Iron stain following an intravenous iron infusion

Iron polymaltose was administered via rapid infusion to a patient with iron deficiency anaemia. During administration, we observed staining and ceased the infusion (Figure, A; 30 minutes after cessation). Staining extended to a large part of the arm, and follow-up at 21 days revealed no change in size (Figure, B). Persistent discolouration of the skin is a risk associated with intramuscular and intravenous iron administration.1,2 It has been reported with multiple iron preparations,3-5 and one study found an incidence of 1.3%.5 Iron staining has been successfully treated with laser therapy, resulting in almost complete disappearance.3 Intravenous infusion sites should be monitored closely for swelling before and during administration to minimise the risk of extravasation causing staining.