Acute Ioderma: an Uncommon Serious Adverse Event Associated with Saturated Solution of Potassium Iodide Treatment

ABSTRACT Objective: The objective of this report is to raise awareness of a case with acute life-threatening ioderma, an uncommon adverse event of saturated solution of potassium iodide (SSKI) therapy. Although extremely rare, physicians should consider the potential for ioderma development as a dangerous but treatable side effect of SSKI therapy. Methods: We present a case report of an uncommon serious adverse event associated with SSKI therapy. Results: A 67-year-old woman with mutlinodular goiter and subclinical hyperthyroidism was prescribed SSKI in preparation for total thyroidectomy. Unfortunately, the patient disregarded the instructions and took the equivalent of three doses at once without any fluid. Six hours later, she developed a reaction characterized by angioedema and hemorrhagic papulo-vesicular rash involving the oral mucosa and her extremities, sparing the trunk. The patient was hospitalized and treated with corticosteroids with prompt resolution of her symptoms. Subsequently, she underwent successful total thyroidectomy. Conclusion: SSKI is considered a safe and effective drug rarely associated with dermatologic side effects. Ioderma is an idiopathic reaction characterized by acneiform, vesicular pustular, hemorrhagic, or urticarial lesions. Other systemic side effects of SSKI include urticaria, fever, eosinophilia, jaundice, pruritus, angioedema, and bronchospasm. High-dose steroid is the therapy of choice, with prompt regression of the symptomatology. Physicians should consider this rare, severe, but treatable condition when prescribing SSKI. Abbreviation: SSKI saturated solution of potassium iodide