Topical cidofovir: a novel treatment for recalcitrant molluscum contagiosum in children infected with human immunodeficiency virus 1.

Two children with human immunodeficiency virus 1 (HIV-1) presented to the dermatology clinic for treatment of disseminated molluscum contagiosum (MC). Both children suffered from severe social isolation because of their facial disfigurement. Their MC lesions were refractory to numerous therapeutic modalities, including liquid nitrogen, cantharidin, and 0.05 % tretinoin gel. Both children had MC lesions, elevated viral loads, and low CD4 T-cell counts despite highly active antiretroviral therapy (HAART) for a median of 24 months. Patient 1, an 8-year-old African American boy, had a CD4 T-cell count of 329/μL and a viral load of 727050 (log 5.86) HIV RNA copies/mL. Patient 2, a 4-year-old-Hispanic boy, had a CD4 T-cell count of 168/μL and a viral load of 429976 (log 5.63) HIV RNA copies/mL Both patients exhibited hundreds of umbilicated pearly and skin-colored papules disseminated over the entire body, including the face and perineal area (Figure, A and C).