# Anaphylactic Reaction to Patent Blue Dye After Supermicrosurgical Lymphaticovenular Anastomosis for the Treatment of Secondary Lymphedema

## TL;DR

A patient had an allergic reaction to patent blue dye used in lymphatic surgery, highlighting the need for safer alternatives.

## Contribution

Reports a rare anaphylactic reaction to patent blue dye during lymphatic surgery and suggests safer alternatives.

## Key findings

- A 71-year-old patient developed anaphylaxis after patent blue dye use during lymphaticovenular anastomosis.
- The reaction included a blue-colored maculopapular exanthema, indicating an allergic response.
- The paper advocates for alternative dyes to avoid life-threatening allergic reactions.

## Abstract

For decades, patent blue dye (PBV) has been utilized for sentinel lymph node biopsy and lymphatic mapping in breast cancer and melanoma staging and treatment. Fistulography and intraoperative display of lymphatic vessels for lymphaticovenular anastomosis (LVA) are frequent applications. Although its anaphylactic potential is well described, PBV is used routinely. We present the case of a 71-year-old female patient, who underwent LVA for the treatment of chronic secondary lymphedema and experienced a postoperative anaphylactic reaction including a blue-colored drug-induced maculopapular exanthema after PBV administration. This article aims to raise awareness of potential life-threatening allergic reactions and propose an alternative to PBV.