Background: The oral administering of iron preparations sometimes produces
adverse gastrointestinal effects. In contrast, cutaneous reactions are extr
emely rare.
Objective: We report a patient with several episodes of generalized pruritu
s and erythematous maculopapular eruption after receiving oral compounds of
iron and on whom desensitization with oral iron was attempted.
Methods: We studied a female with microcytic anemia due to gynecologic bloo
d loss who presented several episodes of cutaneous eruption after receiving
oral compounds of iron. Skin prick-test and two simple-blind, placebo-cont
rolled oral challenges were performed with various iron compounds, and fina
lly desensitization with oral iron was carried out.
Results: Skin prick-test and patch-test with iron preparations were negativ
e. Two simple-blind, placebo-controlled oral challenges were performed and
the patient began experiencing similar cutaneous symptoms. We started a dow
desensitization protocol using increasing doses until the target amount of
the drug was tolerated without adverse effects. The chronic administration
of oral iron therapy once a day for 9 months sustained the desensitized st
ate and the anemia disappeared.
Conclusion: We present methods to effectively manage iron supply for a micr
ocytic anemia patient with cutaneous reactions due to oral iron compounds,
to avoid repeated transfusions, slow desensitization with oral iron was suc
cessfully attempted.