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Other Resources UpToDate PubMed


Contributors: David O'Connell MD, Susan Burgin MD
Other Resources UpToDate PubMed


Bromoderma, the cutaneous manifestation of bromism (chronic bromide intoxication), is a form of halogenoderma that presents as acneiform papules and pustules, vegetative plaques, ulcers, or rarely bullae. It is a neutrophilic dermatosis that occurs in approximately 35% of patients with bromism. The earliest lesions tend to be more pustular, but this progresses to more papular and vegetative presentations in longstanding lesions.

Gastrointestinal (GI) symptoms of bromism include anorexia, weight loss, and nausea. Central nervous system (CNS) manifestations observed are ataxia and tremor along with confusion, delirium, or even full psychosis.

Bromoderma may develop more frequently in patients with renal impairment due to elongation of bromide half-life.

Bromine and bromides can be found in prescription medications (eg, ipratropium bromide) and over-the-counter (OTC) medications (eg, dextromethorphan hydrobromide). Rarely, brominated vegetable oil (BVO) is still used as an emulsifier in citrus-based soft drinks.


L27.8 – Dermatitis due to other substances taken internally

8007005 – Bromoderma

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Bullous impetigo
  • Nonbullous impetigo (and Pyodermatitis vegetans)
  • Ecthyma
  • Acne vulgaris
  • Majocchi granuloma
  • Acute febrile neutrophilic dermatosis
  • Furunculosis
  • Sporotrichosis
  • Deep fungal infections – Blastomycosis, Chromoblastomycosis, Cryptococcosis
  • Botryomycosis
  • Fluoroderma
  • Iododerma
  • Calciphylaxis
  • Pyoderma gangrenosum
  • Cutaneous T-cell lymphoma – plaque and tumor forms
  • Actinomycosis
  • Eumycetoma
  • Skin bacterial abscess
  • Cutaneous tuberculosis and Atypical mycobacterial infection
  • Cutaneous nocardiosis
  • Tertiary syphilis
  • Tularemia

Best Tests

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Management Pearls

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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Last Reviewed:10/27/2021
Last Updated:10/27/2021
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A medical illustration showing key findings of Bromoderma (Skin manifestations) : Bromine compounds exposure, Face, Scaly plaques, Skin ulcers
Clinical image of Bromoderma - imageId=166924. Click to open in gallery.  caption: 'A large purulent bulla with a central superficial ulcer and a rim of erythema on the dorsal hand.'
A large purulent bulla with a central superficial ulcer and a rim of erythema on the dorsal hand.
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