Search
iododerma
Etiology:
- develops after exposure to iodine-containing compounds
- oral & intravenous iodinated contrast dyes, potassium iodide, amiodarone, topical wound care products
- mainly affects patients with renal failure due to impaired renal clearance & accumulation of iodine in the bloodstream
- occurs after months of continuous exposure to oral iodine
- may occur within hours to days after intravenous administration of iodine
Microscopic pathology:
- dense neutrophilic infiltrate on the reticular dermi
- multiple foci of vasculitis with fibrinoid necrosis of vessel walls
- multiple round CD163-positive mononuclear cells with perinuclear halo
- diffuse positivity for myeloperoxidase sparing round cells
* images 1
Clinical manifestations:
- most commonly acneiform pustular eruptions & vegetative plaques
* images [1]
Laboratory:
- markedly elevated serum iodine
Differential diagnosis:
- Sweet syndrome
- pyoderma gangrenosum
Management:
- remove the trigger; no additional treatment may be needed
- topical fusidic acid plus topical betamethasone plus prednisone 0.5 mg/kg/day tapered over 1 month
- cyclosporine & hemodialysis are alternatives.
General
neutrophilic dermatosis
References
- Calvao J, Mira FS, Cardoso JC.
Facial Vegetating Lesions in a Patient With Kidney Failure
JAMA Dermatology. 2021. May 12
PMID: 33978677
https://edhub.ama-assn.org/jn-learning/module/2779642