Pharmacokinetics and Safety of Imiquimod 5% Cream in the Treatment of Molluscum Contagiosum in Children

: Imiquimod cream 5%, a toll‐like receptor 7 agonist, induces α‐interferon upon topical application, prompting off‐label usage to treat children with molluscum contagiosum. We conducted an open‐label study to measure serum drug concentration in children aged 2–12 years with extensive molluscum contagiosum (≥10% total body surface area). Dependent on extent of subject disease and weight, one to three packets (12.5 mg imiquimod per packet) were applied per dose, three times per week for 4 weeks. Serum imiquimod and metabolite concentrations were measured at pre dose and 2, 4, and 8 hours postdose 1 and dose 12. Thirty children were screened; 22 children (64% boys; 91% white; mean age 6.2 ± 2.87 years; median involved body area treated 13.5%) were enrolled. Peak serum imiquimod concentrations following single and multiple dosing were low (