Iodine toxicity after iodinated contrast: New observations in iododerma
Mason Runge, Kiyanna Williams, Thomas Scharnitz, Mio Nakamura, Milad Eshaq, Jennifer Mancuso, Yolanda Helfrich, Scott C. Bresler, Aleodor A. Andea, May P. Chan, Lori Lowe
Abstract
Iododerma is a rare halogenoderma that develops after exposure to iodine-containing compounds. Three cases of iododerma in patients who had recent exposure to intravenous iodinated contrast media and confirmed elevated urine iodine levels are presented. These cases serve to illustrate that lesions can be heterogeneous, can progress rapidly, and frequently have a hemorrhagic component, all of which can cause clinical concern for disseminated infection, neutrophilic dermatosis, or vasculitis. In addition, skin biopsies in all patients demonstrated histologic features that to our knowledge have not previously been described in iododerma: a neutrophilic dermatosis with haloed structures simulating Cryptococcus, with or without vasculitis, a finding causing additional concern for disseminated infection.