povidone-iodine and Facial-Dermatoses

We present a case of a 15-month-old boy with Cornelia de Lange Syndrome (NIPBL gene mutation). On a PSG, central sleep apnea (central apnea-hypopnea index of 19/hour) and nocturnal hypoventilation (transcutaneous CO2 > 50 mmHg for 53% of the night) were found. A positive pressure initiation study was aborted because the patient developed a serious adverse reaction. The differential diagnosis included a skin fragility condition versus an allergic contact dermatitis to the interface; this could be from the povidone-iodine solution used to clean the NiPPV interface or from the plastic of the interface itself. A skin biopsy was performed which was normal. The reaction was likely secondary to an allergic contact dermatitis from the povidone-iodine solution used to clean the NiPPV interface. The patient is currently tolerating NiPPV.

Topics: Anti-Infective Agents, Local; Dermatitis, Allergic Contact; Facial Dermatoses; Humans; Infant; Male; Masks; Polysomnography; Positive-Pressure Respiration; Povidone-Iodine; Severity of Illness Index; Sleep Apnea, Central

Hypersensitivity to drugs is a complex diagnostic challenge. Detailed medical history remains the mainstay of drug hypersensitivity evaluation, which further determines diagnostic procedures, especially the types of skin tests to be performed. The current paper presents the case of a female patient with coexisting features of supposed immunoglobulin E (IgE) dependent allergic hypersensitivity to fluoroquinolones and those of non-IgE dependent allergic hypersensitivity to povidone-iodine. Hypersensitivity was diagnosed based on the appropriately selected skin tests.

Topics: Adult; Anti-Infective Agents, Local; Dermatitis, Atopic; Drug Eruptions; Facial Dermatoses; Female; Fluoroquinolones; Humans; Immunoglobulin E; Povidone-Iodine; Skin Tests

Topics: Adult; Cellulitis; Facial Dermatoses; Humans; Male; Middle Aged; Povidone-Iodine; Suction; Therapeutic Irrigation