Povidone Iodine Skin Sensitivity Observed With Possibly Altered Immune Status

To the Editor.—  We have noted 11 patients who have had their surgical wounds covered with a dressing containing 10% povidone iodine (Betadine). The wounds showed cutaneous erythema, induration, and also papulation, which conformed to the configuration of the dressing. All 11 patients who demonstrated this also showed a similar reaction to a 2×2=cm cotton pledget saturated with 10% povidone iodine. Diagnosis in ten of the 11 patients was suspect for altered immune state.These observations prompted a prospective evaluation of povidone iodine skin sensitivity to confirm our incidental observations and to determine the incidence of skin sensitivity in the population of patients admitted to our surgical service.One hundred sixty-six consecutive patients admitted to the general surgical service were prospectively tested for skin sensitivity to povidone iodine. After we obtained informed consent, a 2×2=cm cotton povidone iodine swab was taped to the medial forearm with a piece of 2=in