Anaphylaxis to polyvinylpyrrolidone after vaginal application of povidone‐iodine

@article{Adachi2003AnaphylaxisTP,
  title={Anaphylaxis to polyvinylpyrrolidone after vaginal application of povidone‐iodine},
  author={Atsuko Adachi and Atsushi Fukunaga and Kazuhiro Hayashi and Makoto Kunisada and Tatsuya Horikawa},
  journal={Contact Dermatitis},
  year={2003},
  volume={48}
}
A 59‐year‐old woman who had had several episodes of contact urticaria after hair treatment, developed anaphylaxis after vaginal application of povidone‐iodine solution for disinfection. Prick tests showed wheal‐and‐flare responses to both povidone‐iodine (0·1% aqueous) and polyvinylpyrrolidone (povidone, PVP) (0·001% aq.), but not to iodine or polyoxy‐ethyrenenonylphenyl ether, both of which are also contained in povidone‐iodine solution. We confirmed that basophils from her peripheral blood… 
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85 Citations
Highly Influential Citations
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Background Citations
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Methods Citations
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Results Citations
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85 Citations

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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 in the presence of serum, which was probably due to a broken skin and vessel condition.
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Although only a small number of povidone-allergic patients has been reported, the widespread use and the serious reactions of reported patients call for a more careful handling of this compound.
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TLDR
Povidone-iodine is the most commonly used antiseptic solution prior to surgery, however, allergic contact dermatitis due to PVP-I has not been extensively documented or reported and hence underevaluated compared to other commonly encountered allergens.
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TLDR
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TLDR
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Allergic reactions to povidone-iodine can be late in onset and, in vaginal surgeries, may present with atypical symptoms such as acute urinary retention secondary to extensive vulvar edema.
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A 65‐year‐old female patient with PVP storage disease presenting as femoral fracture and anemia is reported, with the differential diagnosis, including metastatic carcinoma, chordoma, liposarcoma, and hereditary storage disease.
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