Allergy Asthma Respir Dis.  2015 Sep;3(5):375-379. 10.4168/aard.2015.3.5.375.

Iodinated contrast media-induced fixed drug eruption

• Shim J
• Chung S
• Kim GW
• Sohn KH
• Kim JY
• Kang HR

• KMID: 2218650
• DOI: http://doi.org/10.4168/aard.2015.3.5.375

Abstract

Iodinated contrast media (ICM) can cause not only immediate onset hypersensitivity but also delayed onset hypersensitivity. While the most common form of delayed onset hypersensitivity reaction to ICM is exanthematous eruption, fixed drug eruption (FDE) can occur rarely related to ICM. A 70-year-old male with liver cirrhosis and hepatocellular carcinoma repeatedly experienced erythematous patches on his right forearm and hand 6 hours after exposure to iopromide for computed tomography scan. ICM induced FDE was diagnosed clinically. Intradermal test with 6 kinds of ICM (iobitridol, iohexol, iomeprol, iopamidol, iopromide, and iodixanol) was performed and showed the weakest positive reaction to iohexol compared to the others in 48 hours. After changing iopromide to iohexol based on these results, FDE did not recur. We report here a case of iopromide induced FDE which was successfully prevented by changing ICM to iohexol based on intradermal test results.

Keyword

Contrast media; Drug eruptions; Delayed hypersensitivity; Intradermal tests

MeSH Terms

Aged
Carcinoma, Hepatocellular
Contrast Media
Drug Eruptions*
Forearm
Hand
Humans
Hypersensitivity
Hypersensitivity, Delayed
Intradermal Tests
Iohexol
Iopamidol
Liver Cirrhosis
Male
Contrast Media
Iohexol
Iopamidol

Figure

• 

  Fig. 1 Erythematous patch on the right forearm developed one day after computed tomography scan with iodinated contrast media.

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