Ann Dermatol.  2011 Sep;23(Suppl 1):S33-S35. 10.5021/ad.2011.23.S1.S33.

Fixed Drug Eruption due to Iopromide (Ultravist(R))

• Cha SH
• Kim HS
• Lee JY
• Kim HO
• Park YM

• KMID: 2156746
• DOI: http://doi.org/10.5021/ad.2011.23.S1.S33

Abstract

A 69-year-old male presented with several painful erythematous patches on both palms and trunk several days after receiving iopromide (Ultravist(R), Shering, Berlin, Germany). A fixed drug eruption (FDE) due to iopromide was suspected clinically. However, at that time, the patch test with iopromide at the lesion site gave negative results. Three years later, the patient was mistakenly administered iopromide again and patches with vesicles recurred on the same sites as well as on the genitalia. This episode was repeated once again after 1 year. In all episodes, the skin lesion resolved after application of topical steroids. Although a patch test with iopromide was negative in our case, we made a diagnosis of FDE due to iopromide because the skin lesions occurred again at the previously involved area after re-exposure to iopromide. To date, only three cases of FDE caused by non-ionic monomers have been documented in the English literature. Herein, we report on an interesting case of FDE caused by iopromide.

Keyword

Contrast media; Fixed drug eruption; Iopromide; Non-ionic monomer

MeSH Terms

Aged
Berlin
Contrast Media
Drug Eruptions
Genitalia
Humans
Iohexol
Male
Patch Tests
Skin
Steroids
Contrast Media
Iohexol
Steroids

Figure

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  Fig. 1 Clinical features of the second episode: painful erythematous patches on both palms and trunk several days after receiving iopromide (Ultravist®, Shering, Berlin, Germany).

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  Fig. 2 Clinical features of the third episode: skin lesions on the same area and also on the left arm after re-exposure to iopromide.

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  Fig. 3 Chemical structure of iopromide (Ultravist®, Shering, Berlin, Germany).

Reference

1. Shear NH, Knowles SR, Shapiro L. Wolff K, Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, editors. Cutaneous reactions to drugs. Fitzpatrick's dermatology in general medicine. 2007. 7th ed. New York, USA: McGraw-Hill;359–360.

2. Böhm I, Medina J, Prieto P, Block W, Schild HH. Fixed drug eruption induced by an iodinated non-ionic X-ray contrast medium: a practical approach to identify the causative agent and to prevent its recurrence. Eur Radiol. 2007. 17:485–489.

3. Christiansen C. X-ray contrast media--an overview. Toxicology. 2005. 209:185–187.

4. Watanabe H, Sueki H, Nakada T, Akiyama M, Iijima M. Multiple fixed drug eruption caused by iomeprol (Iomeron), a nonionic contrast medium. Dermatology. 1999. 198:291–294.

5. Webb JA, Stacul F, Thomsen HS, Morcos SK, et al. Members Of The Contrast Media Safety Committee of The European Society of Urogenital Radiology. Late adverse reactions to intravascular iodinated contrast media. Eur Radiol. 2003. 13:181–184.

6. Schick E, Weber L, Gall H. Delayed hypersensitivity reaction to the non-ionic contrast medium iopromid. Contact Dermatitis. 1996. 35:312.

7. Yamauchi R, Morita A, Tsuji T. Fixed drug eruption caused by iopamidol, a contrast medium. J Dermatol. 1997. 24:243–245.