Bromoderma
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Synopsis

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.
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.
Codes
ICD10CM:
L27.8 – Dermatitis due to other substances taken internally
SNOMEDCT:
8007005 – Bromoderma
L27.8 – Dermatitis due to other substances taken internally
SNOMEDCT:
8007005 – Bromoderma
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Impetigo
- Impetigo, non-bullous (and pyoderma vegetans)
- Ecthyma
- Acne
- Majocchi granuloma
- Sweet syndrome
- Furunculosis
- Sporotrichosis
- Deep fungal infections – blastomycosis, chromoblastomycosis, cryptococcosis
- Botryomycosis
- Fluoroderma
- Iododerma
- Calciphylaxis
- Pyoderma gangrenosum
- Cutaneous T-cell lymphoma – plaque and tumor forms
- Actinomycosis
- Eumycetoma
- Abscess
- Cutaneous tuberculosis and atypical mycobacteria
- Nocardiosis
- Syphilis, tertiary
- Tularemia
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Therapy
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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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References
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Last Reviewed:10/27/2021
Last Updated:10/27/2021
Last Updated:10/27/2021