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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
PubMed
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.

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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.

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