Analysis of pediatric outpatient visits uncovers disparities in molluscum contagiosum treatment across medical specialties in the United States

Abstract

Molluscum contagiosum (MC) is a common viral infection that affects the skin of children. This study compared demographic data and treatment patterns for MC patients across US medical specialties. Using the National Ambulatory Medical Care Survey database from 2000 to 2016, we found an average of 471,383 pediatric MC visits yearly. Most visits were made by Caucasians (91.0%) or non-Hispanics (82.9%). Pediatricians handled most cases (46.5%), followed by dermatologists (36.8%) and family medicine physicians (10.6%). Dermatologists saw more Caucasian patients (95% vs. 84%) and more patients with private insurance (83% vs. 73%) than pediatricians. Patients living in non-metropolitan areas were more likely to visit family medicine physicians (55.0%) than pediatricians (26.4%) or dermatologists (16.3%). Pediatricians favored spontaneous resolution (70%) over dermatologists (38%). Pediatricians mainly used terpenoids (12%), steroids (4%), and imiquimod (4%), while dermatologists preferred terpenoids (20%), imiquimod (12%), and curettage (10%). Pediatricians oversee most MC cases, but treatment strategies significantly differ from the best-practice guidelines.