title: Povidone-iodine-induced burn: case report and review of the literature.
abstract: Burns are a rare but potentially serious complication of povidone-iodine use. This rare adverse drug reaction developed in a 38-year-old woman who underwent laparoscopic right ovarian cystectomy and endometrial ablation as a day procedure involving application of the topical antiseptic 10% povidone-iodine solution. Two days later, the patient was admitted to the hospital with burning, pain, itching, marked redness, and blistering extending from her midback to buttocks. A stain on her back also was evident. Partial-thickness chemical burn was diagnosed. Review of the literature yielded 13 other cases of povidone-iodine-induced burn. This underrecognized adverse effect of povidone-iodine application typically occurs when the povidone-iodine has not been allowed to dry or has been trapped under the body of a patient in a pooled dependent position. The burn is usually seen immediately after the procedure or on the next day, and typically heals with minimum scarring within 3-4 weeks with conservative treatment. The commonly postulated mechanism is a chemical burn due to irritation coupled with maceration, friction, and pressure. Given the widespread use of povidone-iodine and the potential for development of infection after a burn, clinicians need to be aware of this possible povidone-iodine-associated adverse drug reaction, and of preventive measures.
authors.affiliation: Department of Pharmacy Services, Toronto General Hospital, University Health Network, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. donna.lowe@uhn.on.ca
authors.forename: Donna O
authors.initials: DO
authors.lastname: Lowe
authors.forename: Sandra R
authors.initials: SR
authors.lastname: Knowles
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Weber
authors.forename: Craig J
authors.initials: CJ
authors.lastname: Railton
authors.forename: Neil H
authors.initials: NH
authors.lastname: Shear
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000891:Anti-Infective Agents, Local / Q000009:adverse effects*; D001414:Bacitracin / Q000627:therapeutic use; D002057:Burns, Chemical / Q000209:etiology*; D005260:Female; D006801:Humans; D011112:Polymyxin B / Q000627:therapeutic use; D011206:Povidone-Iodine / Q000009:adverse effects*
chemical_list: D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; C069612:bacitracin, polymyxin B drug combination; D001414:Bacitracin; D011206:Povidone-Iodine; D011112:Polymyxin B