Abstract
Lidocaine is used widely as an injectable local anesthetic, occasionally as an intravenous drug for cardiac arrhythmias, and increasingly as a topical anesthetic. Reports of allergic contact dermatitis and delayed hypersensitivity reactions to this "amide" anesthetic are limited. We report 16 cases of lidocaine contact allergy seen over 5 years. Concomitant patch-test reactions occurred with neomycin 20% (10 cases), bacitracin 20% (9 cases), fragrance mix 8% (3 cases), balsam of Peru 25% (2 cases), and dibucaine 2.5% and benzocaine 5% (1 case each). Patch tests with lidocaine dilutions (in petrolatum) gave the following results: 10% (3 of 4 positive reactions), 5% (4 of 6 positive reactions), and 1% (3 of 6 positive reactions). Intradermal testing with lidocaine 1%, mepivacaine 2%, and bupivacaine 0.5% was performed on 8 patients, resulting in positive reactions to lidocaine in 3 patients and to mepivacaine in 1 patient. Bupivacaine yielded negative results in each of the 8 patients. Relevance of delayed reactions to injectable lidocaine was definite in 2 cases; past, probable, and unknown in 1 case each; and possible in 11 cases. Delayed hypersensitivity to lidocaine may present as "suture allergy," treatment failure, typical contact allergy, or other local skin or dental reactions. Allergen substitution is based on further patch and intradermal testing, the results of which may be discordant.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 215-220 |
| Number of pages | 6 |
| Journal | Dermatitis |
| Volume | 18 |
| Issue number | 4 |
| DOIs | |
| State | Published - Dec 1 2007 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Dermatology
Cite this
Contact allergy to lidocaine : A report of sixteen cases. / Amado, Antoine; Sood, Apra; Taylor, James S.
In: Dermatitis, Vol. 18, No. 4, 01.12.2007, p. 215-220.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Contact allergy to lidocaine
T2 - A report of sixteen cases
AU - Amado, Antoine
AU - Sood, Apra
AU - Taylor, James S.
PY - 2007/12/1
Y1 - 2007/12/1
N2 - Lidocaine is used widely as an injectable local anesthetic, occasionally as an intravenous drug for cardiac arrhythmias, and increasingly as a topical anesthetic. Reports of allergic contact dermatitis and delayed hypersensitivity reactions to this "amide" anesthetic are limited. We report 16 cases of lidocaine contact allergy seen over 5 years. Concomitant patch-test reactions occurred with neomycin 20% (10 cases), bacitracin 20% (9 cases), fragrance mix 8% (3 cases), balsam of Peru 25% (2 cases), and dibucaine 2.5% and benzocaine 5% (1 case each). Patch tests with lidocaine dilutions (in petrolatum) gave the following results: 10% (3 of 4 positive reactions), 5% (4 of 6 positive reactions), and 1% (3 of 6 positive reactions). Intradermal testing with lidocaine 1%, mepivacaine 2%, and bupivacaine 0.5% was performed on 8 patients, resulting in positive reactions to lidocaine in 3 patients and to mepivacaine in 1 patient. Bupivacaine yielded negative results in each of the 8 patients. Relevance of delayed reactions to injectable lidocaine was definite in 2 cases; past, probable, and unknown in 1 case each; and possible in 11 cases. Delayed hypersensitivity to lidocaine may present as "suture allergy," treatment failure, typical contact allergy, or other local skin or dental reactions. Allergen substitution is based on further patch and intradermal testing, the results of which may be discordant.
AB - Lidocaine is used widely as an injectable local anesthetic, occasionally as an intravenous drug for cardiac arrhythmias, and increasingly as a topical anesthetic. Reports of allergic contact dermatitis and delayed hypersensitivity reactions to this "amide" anesthetic are limited. We report 16 cases of lidocaine contact allergy seen over 5 years. Concomitant patch-test reactions occurred with neomycin 20% (10 cases), bacitracin 20% (9 cases), fragrance mix 8% (3 cases), balsam of Peru 25% (2 cases), and dibucaine 2.5% and benzocaine 5% (1 case each). Patch tests with lidocaine dilutions (in petrolatum) gave the following results: 10% (3 of 4 positive reactions), 5% (4 of 6 positive reactions), and 1% (3 of 6 positive reactions). Intradermal testing with lidocaine 1%, mepivacaine 2%, and bupivacaine 0.5% was performed on 8 patients, resulting in positive reactions to lidocaine in 3 patients and to mepivacaine in 1 patient. Bupivacaine yielded negative results in each of the 8 patients. Relevance of delayed reactions to injectable lidocaine was definite in 2 cases; past, probable, and unknown in 1 case each; and possible in 11 cases. Delayed hypersensitivity to lidocaine may present as "suture allergy," treatment failure, typical contact allergy, or other local skin or dental reactions. Allergen substitution is based on further patch and intradermal testing, the results of which may be discordant.
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UR - http://www.scopus.com/inward/citedby.url?scp=37349032451&partnerID=8YFLogxK
U2 - 10.2310/6620.2007.06059
DO - 10.2310/6620.2007.06059
M3 - Article
C2 - 18021602
AN - SCOPUS:37349032451
VL - 18
SP - 215
EP - 220
JO - Dermatitis
JF - Dermatitis
SN - 1710-3568
IS - 4
ER -