title: Povidone-iodine induced post-surgical irritant contact dermatitis localized outside of the surgical incision area. Report of 27 cases and a literature review.
abstract: BACKGROUND
  Povidone-iodine solution is an antiseptic that is used worldwide as surgical paint and is considered to have a low irritant potential. Post-surgical severe irritant dermatitis has been described after the misuse of this antiseptic in the surgical setting.
  
  
  METHODS
  Between January 2011 and June 2013, 27 consecutive patients with post-surgical contact dermatitis localized outside of the surgical incision area were evaluated. Thirteen patients were also available for patch testing.
  
  
  RESULTS
  All patients developed dermatitis the day after the surgical procedure. Povidone-iodine solution was the only liquid in contact with the skin of our patients. Most typical lesions were distributed in a double lumbar parallel pattern, but they were also found in a random pattern or in areas where a protective pad or an occlusive medical device was glued to the skin. The patch test results with povidone-iodine were negative.
  
  
  CONCLUSIONS
  Povidone-iodine-induced post-surgical dermatitis may be a severe complication after prolonged surgical procedures. As stated in the literature and based on the observation that povidone-iodine-induced contact irritant dermatitis occurred in areas of pooling or occlusion, we speculate that povidone-iodine together with occlusion were the causes of the dermatitis epidemic that occurred in our surgical setting. Povidone-iodine dermatitis is a problem that is easily preventable through the implementation of minimal routine changes to adequately dry the solution in contact with the skin.
authors.affiliation: Servicio de Dermatología, Hospital Universitario Insular, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.
authors.forename: Leopoldo
authors.initials: L
authors.lastname: Borrego
authors.affiliation: Servicio de Dermatología, Hospital Universitario Insular, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.
authors.forename: Noelia
authors.initials: N
authors.lastname: Hernández
authors.affiliation: Servicio de Dermatología, Hospital Universitario Insular, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.
authors.forename: Zaida
authors.initials: Z
authors.lastname: Hernández
authors.affiliation: Servicio de Dermatología, Hospital Universitario Insular, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.
authors.forename: Yeray
authors.initials: Y
authors.lastname: Peñate
mesh_terms: D000328:Adult; D000368:Aged; D000891:Anti-Infective Agents, Local / Q000009:adverse effects*; D017453:Dermatitis, Irritant / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000139:chemically induced; D011206:Povidone-Iodine / Q000009:adverse effects*
chemical_list: D000891:Anti-Infective Agents, Local; D011206:Povidone-Iodine