Iododerma Occurring After Orally Administered Iopanoic Acid

Boudoulas, Olga

doi:10.1001/archderm.1987.01660270125030

Cited by 22 publications

(6 citation statements)

References 9 publications

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“…The diagnosis of iododerma rests on history and clinical findings, because no laboratory or histopathological finding is pathognomonic 2 . Patients present with polymorphous lesions that may mimic Sweet's syndrome, pemphigus vegetans, mycosis fungoides and blastomycosis 2,3,11,12 . Histology of early lesions shows superficial microabscesses and macroabscesses within the epidermis and dermis.…”

Section: Discussionmentioning

confidence: 99%

“…Treatment of iododerma has been attempted with systemic corticosteroids, which may be helpful. However, iododerma is generally a self‐limited condition following cessation of iodide exposure 3,4 . All patients with a history of iododerma should avoid iodine in their diet, medications and radiographic studies 2 …”

Section: Discussionmentioning

confidence: 99%

“…The patient improved and his eruption resolved within 3–4 weeks of stopping the iodine application. In order to ensure that the patient did not have an underlying myeloproliferative disorder, which has been reported in patients with iododerma, a serum protein electrophoresis and serum immunofixation were later performed which did not show a monoclonal spike or protein, respectively 3,8 …”

Section: Case Reportmentioning

confidence: 99%

“…Most cases have been reported following systemic administration of iodides, such as potassium iodide used in the treatment of asthma, hyperthyroidism, chronic bronchitis and sporotrichosis 3 . Iododerma induced by oral or parental administration of iodide‐containing radiographic contrast medium or from treatment with radioactive iodine‐131 for hyperthyroidism has also been described 3,4 . Topical iodine use has only rarely been associated with iododerma 5–7 .…”

Section: Introductionmentioning

confidence: 99%

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Use of topical povidone‐iodine resulting in an iododerma‐like eruption

Massé

Falanga

Zhou

2008

The Journal of Dermatology

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Iododerma is a rare skin eruption that is usually induced by the systemic use of iodide-containing radiographic contrast medium or treatment with oral potassium iodide therapy. Iododerma has also rarely been reported to occur following topical application of iodine. We herein report the case of a 42-year-old male who developed multiple pinpoint pustules on both lower extremities. Three days after the eruption began, the patient started applying topical 10% povidone-iodine solution to the lesions. During this treatment, the lesions enlarged into multiple 2-9-cm pus-filled bullae, limited to the treated areas. Lesional bacterial culture swab and Gram stain were negative. Blood cultures were also negative and the patient's white blood cell count was normal. A punch biopsy specimen revealed pseudoepitheliomatous hyperplasia and dermal-epidermal separation with epidermal necrosis and underlying abscess formation. A superficial and deep perivascular, interstitial and perifollicular infiltrate containing numerous neutrophils, with abscess formation and eosinophils was also seen. This histology was consistent with iododerma and the patient's lesions involuted following cessation of topical iodine use, leaving only post-inflammatory hyperpigmentation. In summary, our patient likely had a folliculitis that was then treated with topical povidone-iodine that led to iododerma. Although it remains possible that the reaction was an unusual contact hypersensitivity response, the ulceration, pseudoepitheliomatous hyperplasia and abscess formation do support an iododerma-like eruption.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Use of topical povidone‐iodine resulting in an iododerma‐like eruption

Massé

Falanga

Zhou

2008

The Journal of Dermatology

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“…While acneiform eruptions are the most common presentation of these halide-induced lesions, ulcerating and crusted vegetative plaques and nodules may also occur 4. The usual sites of iododerma are the face, neck, back or upper extremity, sites most populous with sebaceous glands 124. Histologically, there is pseudoepitheliomatous hyperplasia, intra-epithelial and dermal microabscesses, diffuse dermal neutrophilia, variable numbers of eosinophils and desquamated epithelial cells 4 5.…”

Section: Predominantly Pustular Drug Reactionsmentioning

confidence: 99%

Drug-induced cutaneous pathology

Ramdial¹,

Naidoo²

2009

J Clin Pathol

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Drug-induced cutaneous rashes, whether confined to the skin or part of a systemic disease, are characterised by a spectrum of inflammatory disease patterns that include perivascular dermatitis, nodular and diffuse dermatitis, vesiculobullous lesions, pustular eruptions, sclerodermoid reactions, vasculitis, folliculitis/perifolliculitis and panniculitis. While a single drug can elicit a range of reaction patterns, no reaction pattern is specific for a particular drug. Although the temporal link between initiation of drug therapy and the onset of the drug rash is critical to the diagnosis, drug reactions may also occur during the course of chronic drug ingestion. Clues to the drug-induced nature of the cutaneous eruption include the presence of overlapping histological reaction patterns and incongruent clinical and histopathological features. While eosinophils are an important tell-tale sign of a drug-induced reaction, they may also be conspicuous in skin rashes devoid of a drug association. Furthermore, eosinophils may be sparse or absent in some drug exanthems. Heightened awareness of the mimicry of a wide spectrum of cutaneous pathology by an ever-increasing range of therapeutic agents is pivotal to the diagnosis of drug-induced skin pathology.

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