Transmission occurs by direct mucous membrane or skin contact, leading to autoinoculation.11 Patients should not share towels or bath water and must avoid swimming in public pools to reduce the risk of spreading the infection.12
The individual lesions usually persist for 6 to 9 months but may last for years. Most lesions resolve spontaneously and heal without scarring. Active treatment is used for cosmetic and epidemiologic reasons and includes curettage, cryotherapy, cantharidin, and topical imiquimod.11 There is no consensus about the dosage and duration in current therapy modalities, but some experts suggest liquid cantharidin (0.7%-0.9%).3
Management of GCS? Let it run its course
Most patients with GCS do not need treatment because it is a self-limited benign disease. Although the course is variable and the skin lesions may persist for up to 60 days, the lesions will heal without scarring.2
Postinflammation hyperpigmentation or hypopigmentation is rarely seen. In patients who have severe pruritus, topical antipruritic lotions or oral histamines can provide relief.5 Medium-potency topical steroids may have some benefits, but patients should be closely monitored because there have been reports of exacerbations of lesions with steroid use.2
A good outcome. In the case of our patient, the lesions resolved one week after applying 0.1% mometasone furoate cream once a day.
CORRESPONDENCE Chien-Ping Chiang, MD, Department of Dermatology, Tri-Service General Hospital, No. 325, Sec. 2, Chenggong Road, Neihu District, Taipei City 114, Taiwan R.O.C.; cppchiang@gmail.com