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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Molluscum contagiosum &#40;MC&#41; is a cutaneous viral infection caused by the molluscum contagiosum virus which is commonly observed in children and immunocompromised patients&#46; It presents as single or multiple&#44; discrete white or flesh-colored papules of sizes 1-5&#8239;mm in diameter and with typical central umbilication&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Various treatment modalities available to treat MC include curettage&#44; cryotherapy&#44; extraction by a needle&#44; and topical vesicants such as cantharidin&#44; potassium hydroxide&#44; salicylic acid&#44; retinoids&#44; silver nitrate and phenols&#46; Immunotherapy with imiquimod&#44; nitric oxide&#44; and cimetidine have also been used with variable efficacy&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Cantharidin is a terpenoid derived from the bodies of blister beetle which induces blistering through acantholysis and heals without scarring&#59; hence its efficacy in MC lesions&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> However&#44; there is a paucity of data on its use for facial MC because current convention discourages use of cantharidin on the face&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">We performed a prospective open-labeled uncontrolled interventional study to evaluate the efficacy of cantharidin in treatment naive facial MC in children of &#8804;10 years&#46; Patients with secondary bacterial infections&#44; underlying immunodeficiencies and known hypersensitivity to cantharidin were excluded&#46; Investigations performed in all patients included complete blood count&#44; blood sugar&#44; urine analysis and HIV antibodies&#46; Parents were counseled and written consent was obtained&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Each lesion was treated with cantharidin 0&#46;7&#37; solution &#40;CANTHACUR&#174; Paladin labs Inc&#46;&#41; with a cotton-tipped applicator&#46; Patients were instructed to wash the treated areas only after 4&#8239;hours&#46; Levocetirizine syrup and mupirocin ointment were prescribed for 5 days&#46; Repeat application was performed every 2 weeks of interval for a maximum of 5 doses&#46; Participants and&#47;or their parents were advised about hand hygiene&#44; avoidance of shared personal clothing or items and cessation of scratching&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">At each visit&#44; the clinical response and adverse events were assessed&#46; The number of lesions at the beginning and at the end of the treatment was counted&#46; The response at the end of the treatment was classified as complete &#40;complete clearing-off lesion and appearance of no new lesions&#41;&#44; moderate &#40;clearing-off all treated lesions but persistence or occurrence of new lesions&#41;&#44; mild &#40;clearing of few but not all of the treated lesions and persistence of new lesions&#41;&#44; and none &#40;no response&#41;&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Differences between means of the lesions before and after the treatment were compared by student paired t test&#46; Statistical analysis was done using Graphpad Prism 7 software&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">During the six recruiting months&#44; 71 patients attending our care fulfilled the inclusion criteria and did not exhibit any of the exclusion criteria&#46; Sixty-seven patients consented to participate in the study&#44; out of which four were lost to follow-up&#46; Upon telephonic conversation with each of them&#44; it was confirmed that their drop-outs from the study were unrelated to adverse events caused by a cantharidin&#46; Therefore&#44; the studied population comprised a total of 63 patients&#44; 45 males and 18 &#40;24&#37;&#41; females&#44; with a median age of 6 years &#40;range 1-10&#41;&#46; The median duration of disease was 4 months &#40;range 1-10 months&#41;&#46; Sixty &#40;95&#37;&#41; patients&#44; showed a complete response&#46; In these patients the lesions completely healed with the formation of crusts&#44; which then shaded off within one week &#40;<a class="elsevierStyleCrossRefs" href="#fig0005">Fig&#46; 1 and 2</a>&#41;&#46; One patient each showed a moderate response&#44; and a mild response&#59; whereas 1 patient did not respond&#46; The mean lesion count at a baseline was 11&#46;7&#8239;&#177;&#8239;4&#46;3 and after 5 doses &#40;5 weeks&#41; was 1&#46;9&#8239;&#177;&#8239;0&#46;7 &#40;p&#8239;&#60;&#8239;0&#46;001&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">As expected&#44; 56 &#40;90&#37;&#41; of the treated children experienced blistering in the treated areas which ruptured within 3-4 days and healed with uneventful recovery&#46; Ten patients complained of mild to moderate degree of pain&#46; Three patients developed secondary bacterial infection at the treated sites requiring systemic and topical antibiotic for short duration&#46; Two patients developed hypo&#47;depigmentation at the treated site which healed without any sequelae&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">We found a good acceptance of cantharidin therapy and that patient&#8217;s anxiety at follow-up visits was minimal&#46; Interestingly&#44; we did not observe any residual scars after treatment with cantharidin&#44; which is the most fearful outcome of cantharidin use over face&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Due to its efficacy and tolerability due to painless nature&#44; cantharidin has produced satisfaction with its use ranging from 60-90&#37; in parents and 92&#37; among the dermatologists&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> There are many studies describing the efficacy of cantharidin in MC but of non-facial regions&#46; Till date only one retrospective study has been conducted to evaluate the efficacy of cantharidin in MC involving only face with good results &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">Advantages of cantharidin include quick action&#44; lack of pain at the time of application&#44; and since there is no trauma&#44; the incidence of bleeding is nil&#46; This merits the patient subsequent follow-up office visits and treatment&#46; The limitations in our study include the small sample size&#44; the absence of randomization&#44; and lack of control&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">In conclusion&#44; cantharidin&#44; when applied in a proper and controlled fashion combined with adequate patient and parents&#8217; education&#44; is a safe and effective therapy for childhood MC involving the face&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0065" class="elsevierStylePara elsevierViewall">The authors have nothing to disclose&#46;</p></span></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Zawar V&#44; Pawar M&#44; Singh M&#46; Eficacia del tratamiento con cantaridina del molusco contagioso facial en ni&#241;os peque&#241;os&#58; un estudio prospectivo intervencionista en 67 ni&#241;os&#46; Actas Dermosifiliogr&#46; 2021&#59;112&#58;481&#8211;483&#46;</p>"
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Silverberg et al<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">86&#46;7&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Coloe et al<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">79&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Guzaman AK et al<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">36&#46;2&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Jahnke MN et al<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">8&#46;7&#47;10&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Our study&nbsp;\t\t\t\t\t\t\n
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                          "autores" => array:3 [
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                      "titulo" => "Parental satisfaction&#44; efficacy&#44; and adverse events in 54 patients treated with cantharidin for molluscum contagiosum infection"
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                0 => array:2 [
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                      "titulo" => "Safety and efficacy of topical cantharidin for the treatment of pediatric molluscum contagiosum&#58; a prospective&#44; randomized&#44; double-blind&#44; placebo-controlled pilot trial"
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                        0 => array:2 [
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                            0 => "A&#46;K&#46; Guzman"
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