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When Blue Dye Turns Skin Blue-Effects of Patent Blue V Administration in Lymphatic Surgery: A Case Report

Gaetano Gazzè1, Marco Covotta2, Lorenzo Fabbrocile2

  • 1From the Department of Anesthesia, Intensive Care and Pain Therapy, Policlinico Umberto I, Sapienza University, Rome, Italy.

A&A Practice
|July 1, 2025
PubMed

Patent Blue V (PBV), commonly used for lymph node identification, is regaining popularity with advances in lymphatic reconstruction. Although generally safe, awareness of its potential allergic and adverse effects remains crucial. A 60-year-old woman undergoing breast reconstruction received a 50-mg intradermal bolus of PBV and subsequently developed a generalized bluish skin discoloration, blue-green urine, mild peripheral oxygen saturation (SpO2) reduction, and methemoglobinemia. Diffuse bluish skin discoloration represents a previously unreported manifestation related to PBV use. This case emphasizes the need for caution whenever using PBV, as it can lead to inaccuracies in SpO2 and methemoglobinemia, both potentially harmful to patients.

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