title: Adverse reaction to irrigation with povidone-iodine after deep-impacted, lower third molar extraction.
abstract: Povidone-iodine is most commonly used worldwide because of its germicidal activity, relatively low irritancy or toxicity and low cost. Frequently, povidone-iodine is used as a topical antiseptic for treating and preventing wound infection. In rare cases skin irritation or iododerma-like eruption could represent possible adverse effects due to the oxidative effects of iodine and allergic hypersensitivity reaction. In this report we describe a case of a massive adverse reaction to the irrigation of surgical wound dehiscence with 10 percent povidone-iodine solution after deep-impacted, lower third molar extraction. This reaction was related to a central neurotrophic reflex involving three trigeminal branches and probably due to peripheral chemical insult of mandible nerve. This adverse reaction determined a severe edema and diffuse skin lesions, involving the whole left side of the face mimicking an iododerma-like eruption. These violent symptoms were solved after 60 days. Furthermore, we report a small permanent skin scar in the zygomatic area and transient alterations of facial sensitivity on the affected side which completely disappeared in 6 months.
authors.forename: G
authors.initials: G
authors.lastname: Sammartino
authors.forename: M
authors.initials: M
authors.lastname: Tia
authors.forename: S
authors.initials: S
authors.lastname: Tete
authors.forename: L
authors.initials: L
authors.lastname: Perillo
authors.forename: O
authors.initials: O
authors.lastname: Trosino
mesh_terms: D000328:Adult; D000891:Anti-Infective Agents, Local / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008964:Molar, Third / Q000601:surgery*; D011206:Povidone-Iodine / Q000009:adverse effects*; D013529:Surgical Wound Dehiscence / Q000150:complications; D007507:Therapeutic Irrigation / Q000009:adverse effects / Q000379:methods*; D014081:Tooth Extraction / Q000009:adverse effects*; D014095:Tooth, Impacted
chemical_list: D000891:Anti-Infective Agents, Local; D011206:Povidone-Iodine