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A 69-year-old Malay woman presented with a widespread painful blistering rash, which
had first begun over her neck and trunk, a few hours after a computed tomography scan
performed with 90 mL of iohexol contrast for surveillance of sigmoid adenocarcinoma.
Examination was notable for multiple circular hyperpigmented patches with inlying
blisters and well-demarcated erosions involving her upper lip, neck, abdomen, and
lower extremities (Figures 1 and 2). The total area of detachable epidermis was approximately 25%. Despite extensive
cutaneous involvement, she was otherwise systemically well and clinical parameters
were within normal limits. Further probing elicited a history of similar eruptions
in the past, localized to a few spots on her thighs, which were also involved this
time. Strikingly, each of these episodes occurred within 24 hours following iodinated
contrast media administration and was self-limiting in nature.
Figure 1Multiple well-demarcated erosions over the chest and abdomen, with flaccid bullae
over the right forearm, pubic area, and right thigh.
