Skin Infections

Applying Potassium Hydroxide Fountain Pen to Molluscum Contagiosum Lesions

Dermatology Advisor Contributing Writer
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Molluscum contagiosum occurs in approximately 5% to 18% of HIV-infected people, but is becoming rare in areas of the world with good access to highly effective antiretroviral therapies (HAART).16 It is caused by an infection of the epidermal keratinocytes by the molluscum contagiosum virus, a double-stranded DNA virus belonging to the Poxviridae family.16,17 Patients present with small (≤5 mm in diameter), raised lesions that are usually white, pink, or flesh colored with a dimple or pit in the center.17 The lesions are typically smooth, firm, and pearly appearing, and can affect any area of the body, although they are rarely found on the palms or soles. They may occur as solitary lesions or in groups and typically resolve within 6 to 12 months without any scarring.17 Genital lesions may take longer to resolve, and healing times up to 4 years have been reported.16,17 Photo Credit: Medical Images RM/AL LAMME.

Molluscum contagiosum occurs in approximately 5% to 18% of HIV-infected people, but is becoming rare in areas of the world with good access to highly effective antiretroviral therapies (HAART).16 It is caused by an infection of the epidermal keratinocytes by the molluscum contagiosum virus, a double-stranded DNA virus belonging to the Poxviridae family.16,17

Patients present with small (≤5 mm in diameter), raised lesions that are usually white, pink, or flesh colored with a dimple or pit in the center.17 The lesions are typically smooth, firm, and pearly appearing, and can affect any area of the body, although they are rarely found on the palms or soles. They may occur as solitary lesions or in groups and typically resolve within 6 to 12 months without any scarring.17 Genital lesions may take longer to resolve, and healing times up to 4 years have been reported.16,17

Photo Credit: Medical Images RM/AL LAMME.

The precision of potassium hydroxide fountain pen for molluscum contagiosum lesions reduces side effects in patients.

A potassium hydroxide (KOH) fountain pen has shown efficacy and ease of application in treating molluscum contagiosum, according to an article published in Journal of the American Academy of Dermatology. This pen allows for precise application, reducing the risk for spillage onto surrounding skin that can cause irritation or post-inflammatory hyperpigmentation.

KOH is one of the most popular home treatments for molluscum contagiosum but can cause adverse effects if inadvertently applied to normal skin. However, using a fountain pen, it is easy to apply a 10% solution of KOH directly to the dome of the molluscum contagiosum lesion.

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Methylene blue powder turns the KOH deep blue, allowing practitioners and users to ensure its isolation to the lesion and not to the surrounding skin. In applying the 10% KOH/dye mixture, the nib of the fountain pen should be stroked over the molluscum contagiosum lesion to completely cover the affected area without touching adjoining skin. Application should be gentle to prevent discomfort and trauma to the patient.

The study researchers concluded that “[using] this method, precise application of KOH reduces the chances of irritation and post-inflammatory hyperpigmentation.”

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Reference

Agrawal S, Sharma A, Motiwala M, Dhurat R. A potassium hydroxide fountain pen for precise application over molluscum contagiosum lesions [published online May 28, 2019]. J Am Acad Dermatol. doi: 10.1016/j.jaad.2019.05.058

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