EMLA cream provides rapid pain relief for the curettage of molluscum contagiosum in children with atopic dermatitis without causing serious application-site reactions.

Twenty-nine children with atopic dermatitis, 4 to 9 years of age, were included in an open study of the analgesic efficacy and the application-site reactions produced by EMLA cream 5% at a maximum dose of 10 g applied for 30 minutes under occlusion prior to the curettage of molluscum contagiosum. Molluscum areas with and without eczema were treated. The overall magnitude of pain was assessed first by the child and then by the physician on a four-step verbal rating scale immediately after completion of the curettage. Prior to the surgical treatment, the application site was examined for local skin reactions. Eighty-three percent of the children rated the pain from the surgical procedure as none or mild, while the physicians rated the pain as none or mild in 86% of the children. The application-site reactions were pallor, redness, and edema. These reactions were transient and required no clinical attention. Their incidence or severity did not differ significantly between areas with and without eczema. In conclusion, EMLA cream 5% applied for 30 minutes under an occlusive dressing provides effective local analgesia without serious application-site reactions for the curettage of molluscum contagiosum in children with atopic dermatitis.