A comparative therapeutic trial of varying concentrations of trichloroacetic acid in the treatment of genital molluscum contagiosum in Iraqi men

Background: Molluscum contagiosum (MC) is a common viral skin infection caused by a poxvirus, particularly affecting children and sexually active adults. In men, genital involvement may lead to discomfort and psychological distress. Various treatment modalities exist, but no gold standard has been established. Objective: To evaluate and compare the efficacy and safety of varying concentrations (30%, 50%, and 70%) of trichloroacetic acid (TCA) in treating genital MC in adult Iraqi men. Design: A prospective, open-label, comparative interventional trial. Setting: The samples were collected from private clinics and Al-Karama Teaching Hospital in Wasit Province Patients and Methods: Sixty male patients aged 18-45 years with confirmed genital molluscum contagiosum were randomly assigned into three groups receiving TCA at 30%, 50%, or 70% concentration once every two weeks for up to four sessions. The primary outcome was complete lesion clearance, while secondary outcomes included number of sessions required, recurrence rate, and adverse effects. Results: Complete resolution was achieved in 90% of patients in the 70% TCA group, compared to 65% in the 50% group and 40% in the 30% group. The median number of sessions needed for clearance decreased with higher TCA concentration. Adverse effects such as mild burning, erythema, and post-inflammatory hyperpigmentation were more frequent with 70% TCA but generally well tolerated. Conclusion: Higher concentrations of TCA (70%) demonstrate superior efficacy in clearing genital molluscum contagiosum lesions in men, albeit with slightly increased side effects that are mostly transient and manageable.