Icodextrin cutaneous hypersensitivity - Report of 3 psoriasiform cases

Background: Icodextrin is proposed as a new osmotic agent for use in perito neal dialysis. Because of its recent use, adverse reactions are not well kn own. Cutaneous adverse effects have been described. We report 3 cases of cu taneous hypersensitivity to icodextrin and discuss the pathogenesis of this reaction. Observations: The cutaneous adverse reaction was psoriasiform in our 3 case s. The eruption was generalized with acute generalized exanthematous pustol osis in 1 case, and limited to the palms and sales in 1 case. It occurred 1 0 to 15 days after icodextrin therapy was initiated. In patient 1, the resu lts of a rechallenge with icodextrin were positive. Icodextrin therapy was discontinued in all patients. Conclusions: Some cases of cutaneous reactions to icodextrin have been repo rted in the literature, but they are rare. As in our cases, most eruptions are psoriasiform, limited to the palms and soles, or extensive. Although th e etiology is unclear, a hypersensitivity reaction, with the formation of i mmunocomplexes, is probable.