Cantharidin: a comprehensive review of the clinical literature.

BACKGROUND Cantharidin is a topical vesicant that causes intraepidermal acantholysis with clinical application that includes the removal of warts, molluscum contagiosum (MC), calluses, and acquired perforating dermatoses. OBJECTIVE To provide a comprehensive literature review of the efficacy and safety of cantharidin in the management of various cutaneous conditions. METHODS A PubMed search was conducted using the term "cantharidin" combined with "warts", "plantar warts", "verruca vulgaris", "periungal", "subungual", "topical treatment", "topical therapy for warts", molluscum contagiosum", "perforating collagenosis," and "acantholysis." RESULTS A total of 749 articles were identified and 37 articles met inclusion criteria for this review. The majority of studies show that cantharidin is an effective and safe treatment for removal of warts and MC. Several studies also show potential novel applications of cantharidin in acquired perforating dermatosis, acute herpes zoster, and leishmaniasis. Adverse effects are generally mild but common and should be monitored, particularly in the pediatric population. LIMITATIONS There is a paucity of high-powered clinical studies involving the use of cantharidin. CONCLUSION Topical cantharidin is a safe and effective treatment for warts, molluscum contagiosum, and callus removal, with promising uses in perforating dermatoses and leishmaniasis.