Halogenoderma Clinical Presentation

Updated: Mar 26, 2021
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
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Presentation

History

Papulonodular eruptions, having an acneiform appearance, may occur after the ingestion of certain bromide and iodide preparations. The eruptions are less common with fluoride ingestion.

Fluoride gel preparations for the prophylaxis of postirradiation dental caries may cause fluorodermas when they are applied to the teeth. [22]

Bromoderma is rare and due to ingestion, inhalation, or contact with products containing bromides. [23]

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Physical Examination

Bromoderma tends to be evident as pustules or vegetating plaques; sometimes, plaques with a periphery of pustules appear. In bromoderma, the pustules usually appear on the lower extremities. In iododerma, the pustules are more likely to occur on the face, they appear less papillomatous, and they may become ulcerated.

Iododerma is characterized by vesicular, pustular, hemorrhagic, suppurative, and/or ulcerative lesions that occur on the areas of the skin with the highest concentration of sebaceous glands, such as the face; however, the mucous membranes, the extremities, and the trunk can also be affected. [9] Vegetating iododerma has also been reported to be associated with pulmonary infiltrates. [24] Some patients have had swelling of salivary glands (iodide mumps). [2, 25] Localized pustulosis had been reported after povidone-iodine sitz baths. [26]

Bromoderma is characterized by multiple, vegetative, ulcerating, and pustular lesions with elevated papillomatous borders, especially on the legs. [5, 27] Bromoderma can appear as a follicular eruption on any hair-bearing body surface and can also occur in the butterfly area of the face.

Fluoroderma that develops after the skin is exposed to fluoride-containing preparations resembles iododerma; the papulonodular lesions are numerous and scattered.

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