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Report of 3 Psoriasiform Cases

Annabel Valance, MD; Bénédicte Lebrun-Vignes, MD; Vincent Descamps, MD, PhD; Guillame Queffeulou, MD; Béatrice Crickx, MD

Arch Dermatol. 2001;137:309-310.

Background  Icodextrin is proposed as a new osmotic agent for use in peritoneal dialysis. Because of its recent use, adverse reactions are not well known. Cutaneous adverse effects have been described. We report 3 cases of cutaneous hypersensitivity to icodextrin and discuss the pathogenesis of this reaction.

Observations  The cutaneous adverse reaction was psoriasiform in our 3 cases. The eruption was generalized with acute generalized exanthematous pustulosis in 1 case, and limited to the palms and soles in 1 case. It occurred 10 to 15 days after icodextrin therapy was initiated. In patient 1, the results of a rechallenge with icodextrin were positive. Icodextrin therapy was discontinued in all patients.

Conclusions  Some cases of cutaneous reactions to icodextrin have been reported in the literature, but they are rare. As in our cases, most eruptions are psoriasiform, limited to the palms and soles, or extensive. Although the etiology is unclear, a hypersensitivity reaction, with the formation of immunocomplexes, is probable.

From the Departments of Dermatology (Drs Valance, Lebrun-Vignes, Descamps, and Crickx) and Nephrology (Dr Queffeulou), Hôpital Bichat-Claude Bernard, Assistance Publique-Hopitaux de Paris, Paris, France.

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