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

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Clinical manifestations

• most commonly acneiform pustular eruptions & vegetative plaques

* images

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.

More general terms

• neutrophilic dermatosis