Blue Dye Leading to Blue Eyelids: Anaphylaxis after Sentinel Node Biopsy

Lue dye is used to facilitate Sentinel Node Biopsy (SNB) in breast cancer patients. Hypersensitivity reactions to this blue dye are reported in up to 2.7% of patients. A very rare presentation is the occurrence of anaphylactic shock with blue palpebral angioedema after injection of blue dye. Anaphylaxis is a known cause for the development of angioedema, but blue coloring of the skin appears extraordinary. The blue palpebral angioedema appears to be explained by a systemic effect of the blue dye.