Efficacy of intralesional measles, mumps and rubella vaccine immunotherapy in Molluscum contagiosum: a prospective study

Abstract

Introduction Molluscum contagiosum(MC) is a viral infection of the skin and mucous membrane characterized by single or multiple, pearly white to flesh-colored umbilicated papules. There are certain therapies that increase the cellular immune response either through a topical or systemic approach as cell-mediated immunity plays an important role in the regression of MC. Immunomodulatory medications are relatively newer modalities of treatment that have been more successful for patients with widespread and potentially disfiguring eruptions. Objective To study the effect and safety of Measles, Mumps, and Rubella (MMR) immunotherapy in patients with multiple Mollusca. Patients and methods The study included 200 patients with multiple MC. They were injected with the MMR vaccine intralesionally into 2-3 lesions including the largest mollusca up to a maximum of 0.3 ml in one sitting every 2 weeks for a maximum of 5 treatments at a 2-week interval (week: 0, 2, 4, 6, 8) or till the complete resolution of MC whichever was earlier. The action of the MMR vaccine was assessed by the reduction of the number of lesions and the day of resolution of lesions. The response of all patients at subsequent visits (at second, fourth, sixth, eighth, and 10th week from the initiation of therapy which was taken as week 0) was analyzed. All the patients were subjected to photographic documentation before the initiation of therapy, during therapy, and at 1 month (week 14) and 3 months (week-22) of the follow-up period. Results Out of 200 patients, 184 completed the study. There were 116 males and 84 females. The mean age of study participants was 17.17±12.64 years. At the end of the study complete resolution of MC was seen in 149 (81%) patients, 21 (11.4%) patients had relative response while a poor response was seen in 14 (7.6%) of patients. Mild tolerable pain was seen in 25 (12.5%) patients during injection followed by pigmentary changes in 17 (8.5%) patients and scarring in 12 (6%) patients. Conclusion Intralesional immunotherapy with the MMR vaccine is an effective and safe modality for the treatment of MC.