Rao Sanjana, Bartkus Traci, Gandhi Kushal, Gibson Alex, Ventolini Gary
Texas Tech University Health Sciences Center at the Permian Basin, 800 W 4 Street, Odessa, TX 79763, USA.
Case Rep Womens Health. 2022 Feb 3;34:e00394. doi: 10.1016/j.crwh.2022.e00394. eCollection 2022 Apr.
High infection rates after cesarean section are a major concern in the United States. A majority of antiseptics have irritant properties if they are not used as specified in companies' guidelines. Allergic contact dermatitis caused by povidone‑iodine is infrequent and is misdiagnosed by clinicians who fail to differentiate allergy from irritation. This case report describes an allergic reaction to povidone‑iodine after cesarean section.
A 28-year-old underwent a repeat low transverse cesarean-section at 39 weeks of gestation. The patient informed the medical team that she had no known allergies and no significant past medical history. The new hospital protocol included cleaning the skin over the planned incision site multiple times with povidone‑iodine 7.5% scrub followed by povidone‑iodine 10% paint. The surrounding skin was prepped with chlorhexidine. The patient complained of an allergic reaction on her skin the night after the procedure, with severe itching, and stated that it got progressively worse. The patient was started on an oral regimen of steroids and hydroxyzine. The itching slowly improved and at discharge the patient was continued on hydroxyzine and steroids were discontinued. By the patient's six-week postpartum visit, skin hypopigmentation had completely resolved.
This case illustrates a reaction to povidone‑iodine after cesarean section. This allergic reaction could not be attributed to any other portions of the procedure.
剖宫产术后的高感染率是美国的一个主要担忧。如果大多数防腐剂未按照公司指南规定使用，它们具有刺激性。聚维酮碘引起的过敏性接触性皮炎并不常见，且会被未能将过敏与刺激区分开来的临床医生误诊。本病例报告描述了一例剖宫产术后对聚维酮碘的过敏反应。
一名28岁女性在妊娠39周时接受了再次低位横切口剖宫产。患者告知医疗团队她没有已知的过敏史且既往病史无重大异常。新的医院方案包括用7.5%的聚维酮碘擦洗液多次清洁计划切口部位的皮肤，随后涂抹10%的聚维酮碘。周围皮肤用氯己定进行预处理。术后当晚患者抱怨其皮肤上出现过敏反应，伴有严重瘙痒，并表示情况逐渐恶化。患者开始接受口服类固醇和羟嗪治疗。瘙痒逐渐改善，出院时患者继续服用羟嗪，类固醇药物停用。到患者产后六周复诊时，皮肤色素减退已完全消退。
本病例说明了剖宫产术后对聚维酮碘的反应。这种过敏反应不能归因于手术的任何其他部分。
