Curettage vs Electrodessication for Paediatric Molluscum Contagiosum: Efficacy and Safety Follow-Up Study.

Abstract

Molluscum contagiosum (MC) is a common paediatric cutaneous infection caused by a DNA poxvirus, resulting in lesions that often impair patients' quality of life. Although MC typically resolves spontaneously, parents frequently seek treatment due to cosmetic concerns, pruritus, or fear of lesion spread. Currently, there is no gold standard treatment, and various therapeutic modalities - including curettage and electrodessication (ED) - are utilized in clinical practice. This prospective comparative study aimed to compare efficacy, cosmetic outcome, and patient satisfaction with curettage vs ED as treatment methods in the treatment of MC. The study included 103 paediatric patients presenting with confirmed MC and ≥ 10 lesions (or 5 on face), treated at Sheba Medical Center. Treatment allocation to either curettage or ED was based on guardian preference. Data collected included demographic and clinical characteristics, procedural outcomes, pain levels, and satisfaction ratings. Structured questionnaires were administered 6 weeks post-procedure to evaluate outcomes, including lesion recurrence, infection, remnants, healing duration, and patient/parent satisfaction. Statistical analyses were conducted, with statistical significance defined as p ≤ 0.05. Among the cohort (mean age, 4.37 years; 60% female), 67 (61.7%) patients were treated with curettage and 42 (38.3%) with ED. Most presented with facial lesions (67.96%) and multiple lesion sites (50.5%). Patients treated with curettage reported fewer remnants (42.9% vs 70%, p = 0.007), greater aesthetic satisfaction (p = 0.039), and faster recovery (p = 0.050). Pain levels were comparable between groups, but higher 1-week post-procedure in ED (p = 0.014). Recurrence rates were similar for both methods (49.2% curettage, 35% ED). Curettage offers clear advantages over ED for the treatment of MC, resulting in superior aesthetic outcomes, faster recovery, and lower post-procedural pain. Therefore, curettage should generally be preferred, while ED may be considered for precise interventions in sensitive anatomical areas.