638 Letters

J AM ACAD DERMATOL OCTOBER 2001

huge blister will result. The tape is removed when blistering or soreness develops. The translucent occlusive Blenderm tape (3M Corp) is ideal as it permits monitoring of the lesion. 4. The genitalia are especially sensitive to cantharidin. Minute amounts should be used and care should be taken that the patient remain still for 5 minutes to ensure drying. I do not recall any failures of cantharidin in treating molluscum contagiosum in children. Failures have occurred in adults in hairy locations where it was not possible to occlude the treated site with tape. Ernst Epstein, MD 100 S Ellsworth Ave, Suite 707 San Mateo, CA 94401
16/8/114566 doi:10.1067/mjd.2001.114566

Cantharidin therapy for molluscum contagiosum in children To the Editor: Congratulations to Drs Silverberg, Sidbury, and Mancini (J Am Acad Dermatol 2000;43: 503-7) for so thoroughly documenting the efficacy and safety of cantharidin therapy of molluscum contagiosum in children. Having used cantharidin for the treatment of molluscum contagiosum for more than 25 years, I have never understood why some dermatologists persist in using painful destructive procedures in treating molluscum contagiosum. Unfortunately, the Food and Drug Administration has banned cantharidin preparations in the United States. It is still available to our Canadian colleagues. However, pure cantharidin and flexible collodion can be purchased as separate items from Delasco, which provides the correct premeasured amounts; only combining them is required. No pharmaceutical skills are needed. Attention to the following practical details will ensure success without complications when using cantharidin: 1. A toothpick is my preferred instrument for precise application of a tiny amount of the cantharidin to the lesion. 2. The site must not be touched until the cantharidin is completely dry. Otherwise the cantharidin will be spread and blisters will appear on normal skin. I allow 5 minutes. 3. Resistant lesions can be effectively treated by covering with occlusive tape. The cantharidin in flexible collodion preparation must be completely dry before application of the occlusive tape or a