Adverse reactions to Patent Blue v dye used in sentinel lymph node biopsy for Melanoma
Rughani MG., Swan MC., Adams TS., Middleton MR., Cassell OC.
Sentinel lymph node biopsy (SLNB) is an established investigation used in the management of melanoma, and contributes to disease staging. In the UK, Patent Blue V is injected intra-operatively to help identify the sentinel node. However little is known about the adverse effects associated with Patent Blue V in this technique. We performed a targeted survey of UK surgeons conducting SLNB for melanoma to establish variations in technique and to establish an incidence for adverse reactions. Two cases of adverse reactions were noted from 5,527 SLNB reported in the UK generating an incidence of 0.04%. All surgeons used 2.5% Patent Blue V, injecting between 0.5 and 2 ml, intradermally into the biopsy scar. No cases of anaphylaxis or mortality were reported. There are well-documented adverse reactions from Patent Blue V and Isosulfan Blue in breast cancer sentinel node techniques. The risk of a severe adverse reaction to Patent Blue V for SLNB in melanoma is rare in the UK. Nonetheless it is important for clinicians to be aware of the potential adverse reactions in order that it can be recognised promptly and managed effectively. © 2010 Springer-Verlag.