How has the recently FDA-approved topical cantharidin altered your molluscum treatment algorithm?

I recommend the use of topical cantharidin on a limited number of lesions, since the blistering can be painful especially in young children. Moreover, by treating a few lesions you may trigger an immunologic reaction that results in spontaneous resolution of untreated lesions as well. Moreover, we published the results of a longterm followup study that showed spontaneous resolution in healthy patients without treatment in 6-9 months. I would also watch for secondary infection in treated as well as nontreated patients.