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Novel Insights from Clinical Practice

Anaphylaxis to Polyvinylpyrrolidone in Povidone-Iodine for Impetigo Contagiosum in a Boy with Atopic Dermatitis

Yoshida K.a, b · Sakurai Y.a · Kawahara S.c · Takeda T.a · Ishikawa T.b · Murakami T.b · Yoshioka A.a

Author affiliations

aDepartment of Pediatrics, Nara Medical University School of Medicine, Kashihara, bDepartment of Pediatrics, Nara City Hospital, Nara, and cDepartment of Pediatrics, Oyodo Hospital, Yoshino, Japan

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Int Arch Allergy Immunol 2008;146:169–173

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Article / Publication Details

First-Page Preview
Abstract of Novel Insights from Clinical Practice

Received: March 19, 2007
Accepted: September 18, 2007
Published online: January 18, 2008
Issue release date: May 2008

Number of Print Pages: 5
Number of Figures: 2
Number of Tables: 0

ISSN: 1018-2438 (Print)
eISSN: 1423-0097 (Online)

For additional information: https://www.karger.com/IAA

Abstract

Background: Povidone-iodine (PVP-I) is widely used in antiseptic agents. Immediate allergic reaction to PVP-I preparations is very rare and often overlooked, as it is difficult to diagnose. Polyvinylpyrrolidone (PVP) is thought to play a role in the underlying mechanism. We examined the usefulness of the histamine release test (HRT) for definite diagnosis of PVP allergy. Method: A 9-year-old boy with eosinophilia (1,500/µl) and elevated total IgE (1,376 IU/ml) was suspected clinically of having a PVP allergy, as he had anaphylaxis twice when he was administered a PVP-I solution for impetigo contagiosum. Skin prick tests (SPTs) were performed with a PVP-I solution, PVP (K30), gentamicin sulfate and 2 other medicines containing PVP. HRT was assessed using peripheral blood basophils. Results: SPTs to PVP-I solution, PVP-K30 and other medicines were all negative. Histamine release was observed on stimulation by PVP in the presence of autologous serum, although it was not observed in the absence of autologous serum. Conclusions: This observation was in line with the clinical findings that anaphylaxis had not developed despite the long use of PVP-I solution, but developed only when he received PVP-I solution treatment where basophils could contact PVP-I in the presence of serum, which was probably due to a broken skin and vessel condition. Furthermore, our results suggest the usefulness of HRT in the diagnosis of PVP allergy, and the possibility that negative SPT does not entirely rule out PVP allergy.

© 2008 S. Karger AG, Basel


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Article / Publication Details

First-Page Preview
Abstract of Novel Insights from Clinical Practice

Received: March 19, 2007
Accepted: September 18, 2007
Published online: January 18, 2008
Issue release date: May 2008

Number of Print Pages: 5
Number of Figures: 2
Number of Tables: 0

ISSN: 1018-2438 (Print)
eISSN: 1423-0097 (Online)

For additional information: https://www.karger.com/IAA


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