Dupilumab for the treatment of eczema molluscatum: A pediatric case report and systematic literature review

Atopic dermatitis (AD) may be complicated by disseminated molluscum contagiosum virus (MOCV) infection, known as eczema molluscatum (EM), particularly in children. Topical treatments are not always effective, and although modern systemic immunomodulatory therapies for AD, including use in early childhood, are available, their impact on co-occurring MCV infection is not well documented. We present a 4-year-old child with severe EM that was refractory to conventional topical therapy. She was treated with dupilumab (300 mg subcutaneously every four weeks), which led to a rapid resolution of symptoms and clinical clearance of MOCV-1 infection without adverse events. To contextualize our findings, we performed a systematic literature review, including PubMed, ScienceDirect, Scopus, and Google Scholar, to identify published case descriptions of dupilumab use with co-occurring MOCV infection (PROSPERO ID CRD420251106639). We identified a total of six publications reporting on nine adult patients (mean age: 40 years, range: 21-58 years, 8/9 male). In five of these patients, EM temporarily flared up before resolution. The present report is the first of a child. Our findings, along with existing reports, suggest that dupilumab may be a safe and effective treatment option for AD patients with MOCV infection. Prospective evaluation using standardized outcome measures is warranted.