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Antisépticos para las quemaduras
Gill Norman, Janice Christie, Zhenmi Liu, Maggie J Westby, Jayne M Jefferies, Thomas Hudson, Jacky Edwards, Devi Prasad Mohapatra, Ibrahim A Hassan, Jo C Dumville | 12 julio 2017

Respuestas clínicas Cochrane

Topics

Temas

Flow diagram of inclusion for this update.
Figuras y tablas -
Figure 1

Flow diagram of inclusion for this update.

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Risk of bias table: review authors' judgements about each methodological quality item for each included study.
Figuras y tablas -
Figure 2

Risk of bias table: review authors' judgements about each methodological quality item for each included study.

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Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
Figuras y tablas -
Figure 3

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

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Comparison 1 Topical: 5% imiquimod versus vehicle, Outcome 1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment).
Figuras y tablas -
Analysis 1.1

Comparison 1 Topical: 5% imiquimod versus vehicle, Outcome 1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment).

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Comparison 1 Topical: 5% imiquimod versus vehicle, Outcome 2 Secondary outcome: medium‐term clinical cure (after 3 and up to 6 months after start of treatment).
Figuras y tablas -
Analysis 1.2

Comparison 1 Topical: 5% imiquimod versus vehicle, Outcome 2 Secondary outcome: medium‐term clinical cure (after 3 and up to 6 months after start of treatment).

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Comparison 1 Topical: 5% imiquimod versus vehicle, Outcome 3 Secondary outcome: long‐term clinical cure (> 6 months after start of treatment).
Figuras y tablas -
Analysis 1.3

Comparison 1 Topical: 5% imiquimod versus vehicle, Outcome 3 Secondary outcome: long‐term clinical cure (> 6 months after start of treatment).

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Comparison 1 Topical: 5% imiquimod versus vehicle, Outcome 4 Secondary outcome: short‐term clinical improvement (up to 3 months after start of treatment).
Figuras y tablas -
Analysis 1.4

Comparison 1 Topical: 5% imiquimod versus vehicle, Outcome 4 Secondary outcome: short‐term clinical improvement (up to 3 months after start of treatment).

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Comparison 1 Topical: 5% imiquimod versus vehicle, Outcome 5 Secondary outcome: medium‐term clinical improvement (after 3 and up to 6 months after start of treatment).
Figuras y tablas -
Analysis 1.5

Comparison 1 Topical: 5% imiquimod versus vehicle, Outcome 5 Secondary outcome: medium‐term clinical improvement (after 3 and up to 6 months after start of treatment).

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Comparison 1 Topical: 5% imiquimod versus vehicle, Outcome 6 Secondary outcome: recurrence.
Figuras y tablas -
Analysis 1.6

Comparison 1 Topical: 5% imiquimod versus vehicle, Outcome 6 Secondary outcome: recurrence.

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Comparison 1 Topical: 5% imiquimod versus vehicle, Outcome 7 Secondary outcome: any side effect.
Figuras y tablas -
Analysis 1.7

Comparison 1 Topical: 5% imiquimod versus vehicle, Outcome 7 Secondary outcome: any side effect.

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Comparison 1 Topical: 5% imiquimod versus vehicle, Outcome 8 Secondary outcome: application site reaction.
Figuras y tablas -
Analysis 1.8

Comparison 1 Topical: 5% imiquimod versus vehicle, Outcome 8 Secondary outcome: application site reaction.

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Comparison 1 Topical: 5% imiquimod versus vehicle, Outcome 9 Secondary outcome: severe application site reaction.
Figuras y tablas -
Analysis 1.9

Comparison 1 Topical: 5% imiquimod versus vehicle, Outcome 9 Secondary outcome: severe application site reaction.

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Comparison 2 Topical: 5% imiquimod versus cryospray, Outcome 1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment).
Figuras y tablas -
Analysis 2.1

Comparison 2 Topical: 5% imiquimod versus cryospray, Outcome 1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment).

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Comparison 2 Topical: 5% imiquimod versus cryospray, Outcome 2 Secondary outcome: medium‐term clinical cure (after 3 and up to 6 months after start of treatment).
Figuras y tablas -
Analysis 2.2

Comparison 2 Topical: 5% imiquimod versus cryospray, Outcome 2 Secondary outcome: medium‐term clinical cure (after 3 and up to 6 months after start of treatment).

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Comparison 2 Topical: 5% imiquimod versus cryospray, Outcome 3 Secundary outcome: recurrence.
Figuras y tablas -
Analysis 2.3

Comparison 2 Topical: 5% imiquimod versus cryospray, Outcome 3 Secundary outcome: recurrence.

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Comparison 3 Topical: 5% imiquimod versus 10% potassium hydroxide, Outcome 1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment).
Figuras y tablas -
Analysis 3.1

Comparison 3 Topical: 5% imiquimod versus 10% potassium hydroxide, Outcome 1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment).

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Comparison 3 Topical: 5% imiquimod versus 10% potassium hydroxide, Outcome 2 Secondary outcome: any side effect.
Figuras y tablas -
Analysis 3.2

Comparison 3 Topical: 5% imiquimod versus 10% potassium hydroxide, Outcome 2 Secondary outcome: any side effect.

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Comparison 4 Topical: 10% lemon myrtle oil versus vehicle, Outcome 1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment).
Figuras y tablas -
Analysis 4.1

Comparison 4 Topical: 10% lemon myrtle oil versus vehicle, Outcome 1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment).

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Comparison 5 Topical: 10% benzoyl peroxide cream versus 0.05% tretinoin cream, Outcome 1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment).
Figuras y tablas -
Analysis 5.1

Comparison 5 Topical: 10% benzoyl peroxide cream versus 0.05% tretinoin cream, Outcome 1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment).

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Comparison 6 Topical: 10% potassium hydroxide versus saline, Outcome 1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment).
Figuras y tablas -
Analysis 6.1

Comparison 6 Topical: 10% potassium hydroxide versus saline, Outcome 1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment).

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Comparison 7 Topical: 2.5% potassium hydroxide versus 5% potassium hydroxide, Outcome 1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment).
Figuras y tablas -
Analysis 7.1

Comparison 7 Topical: 2.5% potassium hydroxide versus 5% potassium hydroxide, Outcome 1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment).

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Comparison 7 Topical: 2.5% potassium hydroxide versus 5% potassium hydroxide, Outcome 2 Secondary outcome: short‐term improvement (up to 3 months after start of treatment).
Figuras y tablas -
Analysis 7.2

Comparison 7 Topical: 2.5% potassium hydroxide versus 5% potassium hydroxide, Outcome 2 Secondary outcome: short‐term improvement (up to 3 months after start of treatment).

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Comparison 8 Topical: 10% potassium hydroxide versus 14% salicylic acid + 14% lactic acid, Outcome 1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment).
Figuras y tablas -
Analysis 8.1

Comparison 8 Topical: 10% potassium hydroxide versus 14% salicylic acid + 14% lactic acid, Outcome 1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment).

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Comparison 9 Topical: 10% potassium hydroxide versus curettage, Outcome 1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment).
Figuras y tablas -
Analysis 9.1

Comparison 9 Topical: 10% potassium hydroxide versus curettage, Outcome 1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment).

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Comparison 10 Topical 10% potassium hydroxide versus cryotherapy, Outcome 1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment).
Figuras y tablas -
Analysis 10.1

Comparison 10 Topical 10% potassium hydroxide versus cryotherapy, Outcome 1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment).

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Comparison 10 Topical 10% potassium hydroxide versus cryotherapy, Outcome 2 Secondary outcome: short‐term clinical improvement (up to 3 months after start of treatment).
Figuras y tablas -
Analysis 10.2

Comparison 10 Topical 10% potassium hydroxide versus cryotherapy, Outcome 2 Secondary outcome: short‐term clinical improvement (up to 3 months after start of treatment).

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Comparison 11 Topical: 10% povidone iodine versus 50% salicylic acid plaster, Outcome 1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment).
Figuras y tablas -
Analysis 11.1

Comparison 11 Topical: 10% povidone iodine versus 50% salicylic acid plaster, Outcome 1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment).

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Comparison 12 Topical: 10% povidone iodine alone versus 10% povidone iodine and 50% salicylic plaster, Outcome 1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment).
Figuras y tablas -
Analysis 12.1

Comparison 12 Topical: 10% povidone iodine alone versus 10% povidone iodine and 50% salicylic plaster, Outcome 1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment).

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Comparison 13 Topical: 10% povidone iodine and 50% salicylic acid plaster versus 50% salicylic plaster alone, Outcome 1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment).
Figuras y tablas -
Analysis 13.1

Comparison 13 Topical: 10% povidone iodine and 50% salicylic acid plaster versus 50% salicylic plaster alone, Outcome 1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment).

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Comparison 14 Topical: 0.7% cantharidin versus vehicle, Outcome 1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment)..
Figuras y tablas -
Analysis 14.1

Comparison 14 Topical: 0.7% cantharidin versus vehicle, Outcome 1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment)..

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Comparison 15 Topical: 5% sodium nitrite in 5% salicylic acid versus 5% salicylic acid alone, Outcome 1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment).
Figuras y tablas -
Analysis 15.1

Comparison 15 Topical: 5% sodium nitrite in 5% salicylic acid versus 5% salicylic acid alone, Outcome 1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment).

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Comparison 16 Topical: 12% salicylic acid versus 70% alcohol, Outcome 1 Secondary outcome: medium‐term clinical cure (after 3 and up to 6 months after start of treatment).
Figuras y tablas -
Analysis 16.1

Comparison 16 Topical: 12% salicylic acid versus 70% alcohol, Outcome 1 Secondary outcome: medium‐term clinical cure (after 3 and up to 6 months after start of treatment).

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Comparison 17 Topical: 12% salicylic acid versus 10% phenol/70% alcohol, Outcome 1 Secondary outcome: medium‐term clinical cure (after 3 and up to 6 months after start of treatment).
Figuras y tablas -
Analysis 17.1

Comparison 17 Topical: 12% salicylic acid versus 10% phenol/70% alcohol, Outcome 1 Secondary outcome: medium‐term clinical cure (after 3 and up to 6 months after start of treatment).

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Comparison 18 Topical: 14% salicylic acid + 14% lactic acid versus curettage, Outcome 1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment).
Figuras y tablas -
Analysis 18.1

Comparison 18 Topical: 14% salicylic acid + 14% lactic acid versus curettage, Outcome 1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment).

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Comparison 19 Topical: 70% alcohol versus 10% phenol/70% alcohol, Outcome 1 Secondary outcome: medium‐term clinical cure (after 3 and up to 6 months after start of treatment).
Figuras y tablas -
Analysis 19.1

Comparison 19 Topical: 70% alcohol versus 10% phenol/70% alcohol, Outcome 1 Secondary outcome: medium‐term clinical cure (after 3 and up to 6 months after start of treatment).

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Comparison 20 Topical: iodine versus tea tree oil, Outcome 1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment).
Figuras y tablas -
Analysis 20.1

Comparison 20 Topical: iodine versus tea tree oil, Outcome 1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment).

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Comparison 20 Topical: iodine versus tea tree oil, Outcome 2 Secondary outcome: improvement (up to 3 months after start of treatment).
Figuras y tablas -
Analysis 20.2

Comparison 20 Topical: iodine versus tea tree oil, Outcome 2 Secondary outcome: improvement (up to 3 months after start of treatment).

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Comparison 21 Topical: iodine versus tea tree oil combined with iodine, Outcome 1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment).
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Analysis 21.1

Comparison 21 Topical: iodine versus tea tree oil combined with iodine, Outcome 1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment).

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Comparison 21 Topical: iodine versus tea tree oil combined with iodine, Outcome 2 Secondary outcome: improvement (up to 3 months after start of treatment).
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Analysis 21.2

Comparison 21 Topical: iodine versus tea tree oil combined with iodine, Outcome 2 Secondary outcome: improvement (up to 3 months after start of treatment).

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Comparison 22 Topical: tea tree oil versus tea tree oil combined with iodine, Outcome 1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment).
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Analysis 22.1

Comparison 22 Topical: tea tree oil versus tea tree oil combined with iodine, Outcome 1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment).

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Comparison 22 Topical: tea tree oil versus tea tree oil combined with iodine, Outcome 2 Secondary outcome: improvement (up to 3 months after start of treatment).
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Analysis 22.2

Comparison 22 Topical: tea tree oil versus tea tree oil combined with iodine, Outcome 2 Secondary outcome: improvement (up to 3 months after start of treatment).

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Comparison 23 Systemic: cimetidine versus placebo, Outcome 1 Secondary outcome: medium‐term clinical cure (after 3 months and up to 6 months after start of treatment).
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Analysis 23.1

Comparison 23 Systemic: cimetidine versus placebo, Outcome 1 Secondary outcome: medium‐term clinical cure (after 3 months and up to 6 months after start of treatment).

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Comparison 23 Systemic: cimetidine versus placebo, Outcome 2 Secondary outcome: medium‐term improvement (after 3 months and up to 6 months after start of treatment).
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Analysis 23.2

Comparison 23 Systemic: cimetidine versus placebo, Outcome 2 Secondary outcome: medium‐term improvement (after 3 months and up to 6 months after start of treatment).

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Comparison 24 Systemic: calcarea carbonica versus placebo, Outcome 1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment).
Figuras y tablas -
Analysis 24.1

Comparison 24 Systemic: calcarea carbonica versus placebo, Outcome 1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment).

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Summary of findings for the main comparison. Imiquimod versus vehicle for cutaneous molluscum contagiosum

Imiquimod versus vehicle for cutaneous molluscum contagiosum

Patient or population: molluscum contagiosum
Setting: dermatology outpatient departments
Intervention: topical imiquimod
Comparison: topical vehicle

Outcomes

Anticipated absolute effects* (95% CI)

Relative effect
(95% CI)

№ of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Risk with topical vehicle

Risk with topical imiquimod

Short‐term clinical cure (up to 3 months after start of treatment) (completely cleared short term)
Assessed with: observer assessed
Follow‐up: mean 12 weeks

Study population

RR 1.33
(0.92 to 1.93)

850
(4 RCTs)

⊕⊕⊕○
MODERATE 1

Analysis 1.1

118 per 1000

156 per 1000
(108 to 227)

Medium‐term clinical cure (after 3 months and up to 6 months after start of treatment) (completely cleared medium term)
Assessed with: observer assessed
Follow‐up: mean 16 weeks

Study population

RR 0.88
(0.67 to 1.14)

702
(2 RCTs)

⊕⊕⊕○
MODERATE 2

Analysis 1.2

272 per 1000

239 per 1000
(182 to 310)

Long‐term clinical cure (beyond 6 months after start of treatment) (completely cleared long term)
Assessed with: observer assessed
Follow‐up: mean 28 weeks

Study population

RR 0.97
(0.79 to 1.17)

702
(2 RCTs)

⊕⊕⊕○
MODERATE 2

Analysis 1.3

401 per 1000

389 per 1000
(317 to 469)

Short‐term clinical improvement (up to 3 months after start of treatment)
Assessed with: observer assessed
Follow‐up: mean 12 weeks

Study population

RR 1.14
(0.89 to 1.47)

850
(4 RCTs)

⊕⊕⊕⊕
HIGH 3

Analysis 1.4

487 per 1000

555 per 1000
(433 to 716)

Any adverse effect

Study population

RR 0.97
(0.88 to 1.07)

827
(3 RCTs)

⊕⊕⊕⊕
HIGH 4

Analysis 1.7

688 per 1000

667 per 1000
(606 to 736)

Application site reactions

Study population

RR 1.41
(1.13 to 1.77)

827
(3 RCTs)

⊕⊕⊕○
MODERATE 5

Analysis 1.8. This outcome was not prespecified in our protocol.

261 per 1000

368 per 1000
(295 to 462)

Severe application site reactions

Study population

RR 4.33
(1.16 to 16.19)

827
(3 RCTs)

⊕⊕⊕○
MODERATE 5

Analysis 1.9. This outcome was not prespecified in our protocol.

7 per 1000

29 per 1000
(8 to 110)

*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).

CI: confidence interval; RCT: randomised controlled trial; RR: risk ratio

GRADE Working Group grades of evidence
High quality: We are very confident that the true effect lies close to that of the estimate of the effect.
Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.
Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect.
Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect.

1Downgraded by one level due to imprecision (< 300 events). We decided not to downgrade for risk of bias as out of four studies, the largest three were judged to be at low risk of bias.

2Downgraded by one level due to imprecision (< 300 events). We decided not to downgrade for risk of bias as both studies were judged to be at low risk of bias.

3We decided not to downgrade for risk of bias as out of four studies, the largest three were judged to be at low risk of bias. We also decided not to downgrade for inconsistency as removing one outlier eliminated inconsistency but hardly affected pooled estimate.

4We decided not to downgrade for risk of bias as all three studies were judged to be at low risk of bias.

5Downgraded by one level due to imprecision (< 300 events). We decided not to downgrade for risk of bias as all three studies were judged to be at low risk of bias.

Figuras y tablas -
Summary of findings for the main comparison. Imiquimod versus vehicle for cutaneous molluscum contagiosum
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Table 1. Treatment modalities and examples of references

Treatment class

Treatment modality

Included studies

Other studies

'Doing nothing'

Awaiting natural resolution

—

Olsen 2015; Takemura 1983

Placebo

Antony 2001; Eichenfield 2005; Manchanda 1997b; Paller 2005a; Paller 2005b

—

Surgical treatments

Cryotherapy

Al‐Mutairi 2010

Barton 2002; Caballero 1996; Salmanpour 2006

Curettage

Hanna 2006; Machado 2010

de Waard 1990; Simonart 2008

Curettage with punch

—

Quan 2000

Electric cauterisation

—

He 2001

Physical expression (squeezing)

—

Weller 1999

Pricking

—

Wishart 1903

Pulsed dye laser

—

Hammes 2001

Topical treatments

Acidified nitrite

Ormerod 1999

Gräfe 2000

Adapalene

—

Scheinfeld 2007

Australian lemon myrtle oil

Burke 2004

—

Benzoyl peroxide

Saryazdi 2004

—

Bromogeramine

—

He 2001

Cantharidin

Coloe Dosal 2014; Hanna 2006

Funt 1961; Funt 1979; Ross 2004; Silverberg 2000

Cidofovir

—

Davies 1999; Toro 2000; Zabawski 1999

Diphencyprone

—

Kang 2005; Kyu 1993

Griseofulvin

—

Salmanpour 2006

Honey

—

Holt 2015

Hydrogen peroxide cream

—

Bigardi 2003; Semkova 2014

Hyperthermia

—

Gao 2016

Imiquimod

Al‐Mutairi 2010; Eichenfield 2005; Hanna 2006; Paller 2005a; Paller 2005b; Seo 2010; Theos 2004

Arican 2006; Barba 2001; Bayerl 2003; Hengge 2003; Lim 2003; Liota 2000; Metkar 2008; Skinner 2000; Skinner 2002; Syed 1998

Iodine

Markum 2012

—

Iodine combined with tea tree oil

Markum 2012

—

Milkweed

—

Behl 1970

Povidone iodine plus salicylic acid

Markum 2012; Ohkuma 1990

—

Phenol

Leslie 2005

Weller 1999

Podophyllotoxin (HIV patients)

—

Markos 2001; Syed 1994; Teilla‐Hamel 1996

Potassium hydroxide

Bazza 2007; Machado 2010; Seo 2010; Short 2006; Uçmak 2013

Metkar 2008; Romiti 1999; Romiti 2000

Retinoic acid

—

Hund 1975

Salicylic acid

Hanna 2006; Leslie 2005; Ohkuma 1990

—

Salicylic acid combined with lactic acid

Machado 2010

—

Salicylic acid combined with sodium nitrite

Ormerod 1999

—

Silver nitrate

—

Niizeki 1999

Tea tree oil

Markum 2012

—

Tretinoin

Saryazdi 2004

—

Yellow oxide of mercury

—

Davis 1896

Systemic treatments

Cimetidine

Antony 2001

Cunningham 1998; Dohil 1996; Sharma 1998; Yasher 1999

Calcarea carbonica (homeopathy)

Manchanda 1997b

Manchanda 1997a

Griseofulvin

—

Singh 1977

Combinations of above

Potassium iodide followed by X‐rays

—

Cope 1915

Figuras y tablas -
Table 1. Treatment modalities and examples of references
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Comparison 1. Topical: 5% imiquimod versus vehicle

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment) Show forest plot

4

850

Risk Ratio (M‐H, Random, 95% CI)

1.33 [0.92, 1.93]

2 Secondary outcome: medium‐term clinical cure (after 3 and up to 6 months after start of treatment) Show forest plot

2

702

Risk Ratio (M‐H, Random, 95% CI)

0.88 [0.67, 1.14]

3 Secondary outcome: long‐term clinical cure (> 6 months after start of treatment) Show forest plot

2

702

Risk Ratio (M‐H, Random, 95% CI)

0.97 [0.79, 1.17]

4 Secondary outcome: short‐term clinical improvement (up to 3 months after start of treatment) Show forest plot

4

850

Risk Ratio (M‐H, Random, 95% CI)

1.14 [0.89, 1.47]

5 Secondary outcome: medium‐term clinical improvement (after 3 and up to 6 months after start of treatment) Show forest plot

2

702

Risk Ratio (M‐H, Random, 95% CI)

0.97 [0.87, 1.08]

6 Secondary outcome: recurrence Show forest plot

2

175

Risk Ratio (M‐H, Random, 95% CI)

2.70 [0.31, 23.23]

7 Secondary outcome: any side effect Show forest plot

3

827

Risk Ratio (M‐H, Random, 95% CI)

0.97 [0.88, 1.07]

8 Secondary outcome: application site reaction Show forest plot

3

827

Risk Ratio (M‐H, Random, 95% CI)

1.41 [1.13, 1.77]

9 Secondary outcome: severe application site reaction Show forest plot

3

827

Risk Ratio (M‐H, Random, 95% CI)

4.33 [1.16, 16.19]
Figuras y tablas -
Comparison 1. Topical: 5% imiquimod versus vehicle
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Comparison 2. Topical: 5% imiquimod versus cryospray

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment) Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

2 Secondary outcome: medium‐term clinical cure (after 3 and up to 6 months after start of treatment) Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

3 Secundary outcome: recurrence Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected
Figuras y tablas -
Comparison 2. Topical: 5% imiquimod versus cryospray
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Comparison 3. Topical: 5% imiquimod versus 10% potassium hydroxide

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment) Show forest plot

2

67

Risk Ratio (M‐H, Random, 95% CI)

0.65 [0.46, 0.93]

2 Secondary outcome: any side effect Show forest plot

2

67

Risk Ratio (M‐H, Random, 95% CI)

0.68 [0.25, 1.81]
Figuras y tablas -
Comparison 3. Topical: 5% imiquimod versus 10% potassium hydroxide
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Comparison 4. Topical: 10% lemon myrtle oil versus vehicle

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment) Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected
Figuras y tablas -
Comparison 4. Topical: 10% lemon myrtle oil versus vehicle
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Comparison 5. Topical: 10% benzoyl peroxide cream versus 0.05% tretinoin cream

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment) Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected
Figuras y tablas -
Comparison 5. Topical: 10% benzoyl peroxide cream versus 0.05% tretinoin cream
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Comparison 6. Topical: 10% potassium hydroxide versus saline

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment) Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected
Figuras y tablas -
Comparison 6. Topical: 10% potassium hydroxide versus saline
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Comparison 7. Topical: 2.5% potassium hydroxide versus 5% potassium hydroxide

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment) Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

2 Secondary outcome: short‐term improvement (up to 3 months after start of treatment) Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected
Figuras y tablas -
Comparison 7. Topical: 2.5% potassium hydroxide versus 5% potassium hydroxide
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Comparison 8. Topical: 10% potassium hydroxide versus 14% salicylic acid + 14% lactic acid

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment) Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected
Figuras y tablas -
Comparison 8. Topical: 10% potassium hydroxide versus 14% salicylic acid + 14% lactic acid
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Comparison 9. Topical: 10% potassium hydroxide versus curettage

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment) Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected
Figuras y tablas -
Comparison 9. Topical: 10% potassium hydroxide versus curettage
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Comparison 10. Topical 10% potassium hydroxide versus cryotherapy

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment) Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

2 Secondary outcome: short‐term clinical improvement (up to 3 months after start of treatment) Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected
Figuras y tablas -
Comparison 10. Topical 10% potassium hydroxide versus cryotherapy
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Comparison 11. Topical: 10% povidone iodine versus 50% salicylic acid plaster

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment) Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected
Figuras y tablas -
Comparison 11. Topical: 10% povidone iodine versus 50% salicylic acid plaster
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Comparison 12. Topical: 10% povidone iodine alone versus 10% povidone iodine and 50% salicylic plaster

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment) Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected
Figuras y tablas -
Comparison 12. Topical: 10% povidone iodine alone versus 10% povidone iodine and 50% salicylic plaster
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Comparison 13. Topical: 10% povidone iodine and 50% salicylic acid plaster versus 50% salicylic plaster alone

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment) Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected
Figuras y tablas -
Comparison 13. Topical: 10% povidone iodine and 50% salicylic acid plaster versus 50% salicylic plaster alone
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Comparison 14. Topical: 0.7% cantharidin versus vehicle

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment). Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected
Figuras y tablas -
Comparison 14. Topical: 0.7% cantharidin versus vehicle
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Comparison 15. Topical: 5% sodium nitrite in 5% salicylic acid versus 5% salicylic acid alone

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment) Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected
Figuras y tablas -
Comparison 15. Topical: 5% sodium nitrite in 5% salicylic acid versus 5% salicylic acid alone
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Comparison 16. Topical: 12% salicylic acid versus 70% alcohol

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Secondary outcome: medium‐term clinical cure (after 3 and up to 6 months after start of treatment) Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected
Figuras y tablas -
Comparison 16. Topical: 12% salicylic acid versus 70% alcohol
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Comparison 17. Topical: 12% salicylic acid versus 10% phenol/70% alcohol

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Secondary outcome: medium‐term clinical cure (after 3 and up to 6 months after start of treatment) Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected
Figuras y tablas -
Comparison 17. Topical: 12% salicylic acid versus 10% phenol/70% alcohol
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Comparison 18. Topical: 14% salicylic acid + 14% lactic acid versus curettage

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment) Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected
Figuras y tablas -
Comparison 18. Topical: 14% salicylic acid + 14% lactic acid versus curettage
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Comparison 19. Topical: 70% alcohol versus 10% phenol/70% alcohol

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Secondary outcome: medium‐term clinical cure (after 3 and up to 6 months after start of treatment) Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected
Figuras y tablas -
Comparison 19. Topical: 70% alcohol versus 10% phenol/70% alcohol
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Comparison 20. Topical: iodine versus tea tree oil

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment) Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

2 Secondary outcome: improvement (up to 3 months after start of treatment) Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected
Figuras y tablas -
Comparison 20. Topical: iodine versus tea tree oil
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Comparison 21. Topical: iodine versus tea tree oil combined with iodine

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment) Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

2 Secondary outcome: improvement (up to 3 months after start of treatment) Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected
Figuras y tablas -
Comparison 21. Topical: iodine versus tea tree oil combined with iodine
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Comparison 22. Topical: tea tree oil versus tea tree oil combined with iodine

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment) Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

2 Secondary outcome: improvement (up to 3 months after start of treatment) Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected
Figuras y tablas -
Comparison 22. Topical: tea tree oil versus tea tree oil combined with iodine
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Comparison 23. Systemic: cimetidine versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Secondary outcome: medium‐term clinical cure (after 3 months and up to 6 months after start of treatment) Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

2 Secondary outcome: medium‐term improvement (after 3 months and up to 6 months after start of treatment) Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected
Figuras y tablas -
Comparison 23. Systemic: cimetidine versus placebo
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Comparison 24. Systemic: calcarea carbonica versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Primary outcome: short‐term clinical cure (up to 3 months after start of treatment) Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected
Figuras y tablas -
Comparison 24. Systemic: calcarea carbonica versus placebo
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