Use of topical povidone-iodine resulting in an iododerma-like eruption.
Use of topical povidone-iodine resulting in an iododerma-like eruption.
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局部使用聚维酮碘会导致碘皮病样皮疹。
DOI：
10.1111/j.1346-8138.2008.00554.x
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发表时间：
2008
期刊：
影响因子：
--
通讯作者：
Zhou,LindaHua
中科院分区：
文献类型：
--
作者：
Massé,Maureen;Falanga,Vincent;Zhou,LindaHua
碘皮病是一种罕见的皮疹，通常由全身使用含碘放射造影剂或口服碘化钾治疗引起。碘皮病也很少报告在局部应用碘后发生。我们在此报告一位42岁男性，双下肢出现多发性针尖状脓疱。出疹开始后3天，患者开始在病变处局部使用10%聚维酮碘溶液。治疗期间，病变扩大为多个2-9 cm的脓性大疱，局限于治疗区域。病灶细菌培养拭子和革兰氏染色均为阴性。血培养也呈阴性，患者的白色血细胞计数正常。穿刺活检标本显示假上皮瘤样增生和真皮-表皮分离伴表皮坏死和潜在脓肿形成。还观察到浅表和深部血管周围、间质和滤泡周围浸润，含有大量中性粒细胞，伴脓肿形成和嗜酸性粒细胞。该组织学与碘皮病一致，停止局部碘使用后患者病变消退，仅留下炎症后色素沉着过度。总之，我们的患者可能患有毛囊炎，然后局部使用聚维酮碘治疗，导致碘皮病。尽管该反应仍可能是一种不寻常的接触性超敏反应，但溃疡、假上皮瘤样增生和脓肿形成确实支持碘皮病样皮疹。
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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