Delayed Onset Icodextrin Induced Exfoliative Dermatitis

S. Dwarak, M. Mathew, P. Rajeevalochana, P. Rudreshwar, G. Abraham
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Abstract

We report a case of a 69 year old female with Chronic Kidney Disease and Coronary Artery Disease (DVD) on regular Automated peritoneal dialysis(10 Litres of 2.5% Dextrose exchanges at night )who was admitted for planned PTCA. Her PD prescription was modified with add on icodextrin 7.5% as day dwell in view of insufficient ultrafiltration with APD. The patient developed pruritic maculopapular rash which progressed to generalised exfoliative dermatitis 3 days after stoppage of Icodextrin. Peripheral blood eosinophilia was noted. Late onset Exfoliative dermatitis is a rare complication of Icodextrin based PD. Awareness of this entity is important for nephrologists and dermatologists to avoid misdiagnosis.
迟发性醋酸糊精致剥脱性皮炎
我们报告一例患有慢性肾脏疾病和冠状动脉疾病(DVD)的69岁女性患者,定期进行自动腹膜透析(每晚10升2.5%葡萄糖交换),并因计划PTCA而入院。鉴于APD超滤不足,对其PD处方进行了修改,添加了7.5%的icodextrin作为日停留剂。患者停药3天后出现瘙痒性斑疹,发展为全身性剥脱性皮炎。外周血嗜酸性粒细胞增多。晚发剥脱性皮炎是一种罕见的并发症,以Icodextrin为基础的PD。意识到这个实体对肾病学家和皮肤科医生避免误诊是很重要的。
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