VEGETATING IODODERMA AND PULMONARY EOSINOPHILIC INFILTRATION. A SIMPLE CO-OCCURENCE?

Iodine derivatives are used as contrast media in radiology and as drugs to treat pulmonary disorders as well as erythema nodosum. Their use may cause side effects such as dysfunction of the tyroid and salivary glands or allergic reaction. Other side effects are the so-called "iodides":, skin eruptions characterized by papules and pustoles. These lesions can evolve towards characteristic nodules, seen in typical vegetating pyodermitis or iododerma. In its initial phase this disease is characterized by papules and pustoles that evolve in paseudotumoral vegetating lesions. Different pathogenetic hipotheses have been proposed to explain the onset of iododerma in patients exposed to contrast media or drugs containing iodine such as an immunological mechanism , suggest by the frequent presence of eosinophils in both skin lesions and peripheral blood, or an direct mechanism : iodine may directly activate eosinophils. Iododerma have been reported associated with multiple myeloma, lymphomas, arthritis, panarteritis nodosa, subacute glomerulonephritis and pulmonary disorders. We observed a 62-years-old womano with vegetating, soft nodular lesions sited on her ears and fingers, fever and mild dysponea and whistlings and wheezing: a case of vegetating iododerma with noticeable pulmonary infiltration. The cutaneous lesions disappeared within 10 days from suspension of potassium iodide and administration of clarithromycin.