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Sensitization to povidone-iodine.
W G van Ketel1, W H van den Berg
1Department of Occupational Dermatology, Free University Academic Hospital, Amsterdam, The Netherlands.
Dermatologic Clinics
|January 1, 1990
Summary
Adverse skin reactions to povidone-iodine (Betadine) were observed in eight patients. Patch tests indicated allergy to povidone-iodine, not iodine itself, suggesting a specific hypersensitivity.
Area of Science:
- Dermatology
- Allergology
- Clinical Medicine
Background:
- Povidone-iodine (PI) is a widely used antiseptic with a broad spectrum of activity.
- Adverse skin reactions to PI have been reported, but the underlying mechanisms are not fully understood.
- Distinguishing between allergy to PI and its components is crucial for patient management.
Purpose of the Study:
- To investigate the cause of adverse skin reactions in patients exposed to povidone-iodine preparations.
- To determine if hypersensitivity is due to povidone-iodine itself or to free iodine.
- To evaluate the role of potassium iodide in povidone-iodine allergy.
Main Methods:
- Case series describing eight patients with suspected povidone-iodine allergy.
- Patch testing with povidone-iodine (5-10% in petrolatum) and Betadine formulations (Solution, Ointment, Scrub).
- Potassium iodide (5-20% in petrolatum) and iodine tincture open tests were performed in a subset of patients.
Main Results:
- All eight patients showed positive patch test reactions to povidone-iodine or Betadine products.
- Five of eight patients had negative reactions to potassium iodide patch tests.
- Three patients tested with iodine tincture showed no adverse reactions.
Conclusions:
- Allergic contact dermatitis to povidone-iodine is likely due to sensitization to the povidone-iodine complex itself.
- Hypersensitivity to povidone-iodine does not appear to be based on an allergy to iodine.
- These findings aid in diagnosing and managing povidone-iodine-related skin reactions.