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Background/Objectives <p>Molluscum contagiosum affects up to 11.5% of children, yet optimal treatment remains uncertain. Previous systematic reviews included mixed adult/pediatric populations, limiting applicability to children. We performed the first pediatric-specific network meta-analysis comparing molluscum contagiosum treatment efficacy and safety.</p> Methods <p>We searched MEDLINE, Embase, Cochrane Library, and Web of Science through December 2025 for controlled trials evaluating molluscum contagiosum treatments in children. Two reviewers independently selected studies, extracted data, and assessed risk of bias using Cochrane Risk of Bias 2 and ROBINS-I tools. We performed frequentist network meta-analysis with random-effects modeling, calculating risk ratios (RR) with 95% confidence intervals (CI). Treatments were ranked using Surface Under Cumulative Ranking (SUCRA) scores. This systematic review and network meta-analysis was registered in PROSPERO (registration number CRD420251040622).</p> Results <p>Eighteen controlled trials involving 2377 pediatric participants evaluating 15 treatments were included. The network demonstrated consistency (inconsistency <i>p</i> = 0.77). Among treatments evaluated in multiple studies, salicylic acid + lactic acid 16.7% (RR 3.16, 95% CI 1.81–5.52, SUCRA 86.0%), cantharidin 0.7% (RR 3.25, 95% CI 1.39–7.58, SUCRA 81.2%), and potassium hydroxide 10% (RR 3.05, 95% CI 1.77–5.24, SUCRA 78.6%) demonstrated superior efficacy versus placebo. Single-study treatments including <i>Backhousia citriodora</i> oil and <i>Candida albicans</i> antigen achieved highest rankings but require validation. Potassium hydroxide demonstrated concentration-dependent efficacy and adverse events.</p> Conclusions <p>Salicylic acid + lactic acid 16.7%, cantharidin 0.7%, and potassium hydroxide 10% demonstrate superior efficacy for pediatric molluscum contagiosum with robust multi-study evidence. Treatment selection should balance efficacy, safety, and patient factors. Top-ranked single-study treatments require validation before clinical recommendations.</p>

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Molluscum Contagiosum Treatments in Children: A Systematic Review with Network Meta-Analysis

  • 期刊论文

  • 发表日期：

    2026年6月26日

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  • Letícia Rocha Campos,
  • Gisella Chiara Carpi,
  • Ana Beatriz Nardelli da Silva,
  • Beatriz Ximenes Mendes,
  • Fabiana Castro Porto Silva Lopes

摘要

Background/Objectives

Molluscum contagiosum affects up to 11.5% of children, yet optimal treatment remains uncertain. Previous systematic reviews included mixed adult/pediatric populations, limiting applicability to children. We performed the first pediatric-specific network meta-analysis comparing molluscum contagiosum treatment efficacy and safety.

Methods

We searched MEDLINE, Embase, Cochrane Library, and Web of Science through December 2025 for controlled trials evaluating molluscum contagiosum treatments in children. Two reviewers independently selected studies, extracted data, and assessed risk of bias using Cochrane Risk of Bias 2 and ROBINS-I tools. We performed frequentist network meta-analysis with random-effects modeling, calculating risk ratios (RR) with 95% confidence intervals (CI). Treatments were ranked using Surface Under Cumulative Ranking (SUCRA) scores. This systematic review and network meta-analysis was registered in PROSPERO (registration number CRD420251040622).

Results

Eighteen controlled trials involving 2377 pediatric participants evaluating 15 treatments were included. The network demonstrated consistency (inconsistency p = 0.77). Among treatments evaluated in multiple studies, salicylic acid + lactic acid 16.7% (RR 3.16, 95% CI 1.81–5.52, SUCRA 86.0%), cantharidin 0.7% (RR 3.25, 95% CI 1.39–7.58, SUCRA 81.2%), and potassium hydroxide 10% (RR 3.05, 95% CI 1.77–5.24, SUCRA 78.6%) demonstrated superior efficacy versus placebo. Single-study treatments including Backhousia citriodora oil and Candida albicans antigen achieved highest rankings but require validation. Potassium hydroxide demonstrated concentration-dependent efficacy and adverse events.

Conclusions

Salicylic acid + lactic acid 16.7%, cantharidin 0.7%, and potassium hydroxide 10% demonstrate superior efficacy for pediatric molluscum contagiosum with robust multi-study evidence. Treatment selection should balance efficacy, safety, and patient factors. Top-ranked single-study treatments require validation before clinical recommendations.