A 10-year retrospective study on benzocaine allergy in the United Kingdom

Sidhu, Shireen; Shaw, S.; Wilkinson, J. D.

doi:10.1016/s1046-199x(99)90000-3

Cited by 42 publications

(26 citation statements)

References 7 publications

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“…Surprisingly, however, both patients with benzocaine reactivity tolerated chloroprocaine. This lack of cross-reactivity of benzocaine with other caines has been noted previously 11 and therefore would suggest that classification is too simplistic.…”

Section: Discussionmentioning

confidence: 55%

“…5,9 Benzocaine appears to be the most common cause of type IV reactions to local anesthetics, 10 although this may not be true in some countries. 11 This topical anesthetic is present in numerous over-thecounter products used for sunburn, vaginal irritation, sexual enhancement, hemorrhoids; tetracaine, another p-amino benzoic acid ester, has been associated with type IV reactions in cosmetic as well urological applications. 12,13 EMLA crème is a combination of lidocaine 2.5% and prilocaine 2.5%.…”

Section: Discussionmentioning

confidence: 99%

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Delayed-type hypersensitivity (type IV) reactions in dental anesthesia

Melamed

Beaucher

2007

allergy asthma proc

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The recommended methodology of evaluating patients who have presented with reactions to local anesthetics consists of epicutaneous skin testing and serial subcutaneous challenge. However, the role of type IV reactions in this group has been poorly documented. Epicutaneous routine testing and subcutaneous challenge to local anesthetic was performed, as well as patch testing and subcutaneous rechallenge of both at 24 and 48 hours with evaluation up to 72 hours was performed. Three patients presented with a history of localized edema after dental anesthesia. All had negative lidocaine and mepivacaine testing as well as negative lidocaine challenge on evaluation at 1 hour. The first patient, who had previously reacted to EMLA, reacted to both lidocaine and mepivacaine patch testing and challenge, with delayed swelling at 24 and 48 hours after challenge. This patient subsequently tolerated the ester anesthetic chloroprocaine. Two other patients had strong histories of contact dermatitis. Patch testing and challenge with lidocaine was negative, but strong reactions were found to benzocaine on patch testing. Patients undergoing local anesthetic testing should be screened historically for features and risk factors associated with type IV reactions. This should be considered in patients who react to multiple amide anesthetics, who have delayed swelling, or who have a history of severe contact dermatitis. We confirm previous data showing that patients reacting to benzocaine can tolerate lidocaine and that lidocaine-allergic individuals can tolerate ester anesthetics.

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Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Delayed-type hypersensitivity (type IV) reactions in dental anesthesia

Melamed

Beaucher

2007

allergy asthma proc

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“…Moreover, due to the low cross-reactivity between amide anesthetics, if a patient is found to be allergic to a particular amide anesthetic, a different amide may be utilized [ 93 ] . Cross-reactivity between the PABA derivatives, ester anesthetics, and other PABA-like derivatives found in sunscreens and creams, PPD based permanent hair dyes (see #73), aniline dyes, hydrochlorothiazide, sulfonamide antibiotics, as well as sulfonylurea diabetic medications [ 97,98 ] .…”

Section: -12 Caine Anesthetics (Topical) : Benzocaine Tetracaine mentioning

confidence: 99%

Practical Patch Testing and Chemical Allergens in Contact Dermatitis

Jacob¹,

Herro²

2013

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“…[33][34][35][36] Despite the extensive use of isopropyl alcohol in hospital practice (eg, prepackaged cleansing swabs), there are only a handful of reports of ACD. 41,42 Local anesthetics are classified as either ester or amide compounds (Table 2). 39,40 Martin-Garcia and colleagues presented a 28-year-old woman with ACD secondary to use of a blue permanent marker (Edding 3000, Edding International GmbH, Ahrensburg, Germany) to outline the liposuction area.…”

Section: Alcoholsmentioning

confidence: 99%

“…37,38 Permanent Marker ACD caused by a permanent marker is an infrequent finding, with only two reports published. Esters are associated with a higher incidence of allergic reactions 41,42 owing to a p-aminobenzoic acid (PABA) metabolite formed during the degradation process by plasma pseudocholinesterase. 39 This patient patch-tested positive to Abitol, a modified product of colophony.…”

Section: Alcoholsmentioning

confidence: 99%