Contact allergy to lidocaine

Abstract

Two cases of contact allergy to lidocaine are reported. They also reacted to chemically related anesthetics of the amide type: one to bupivacaine, mepivacaine and prilocaine and the other to mepivacaine only. The patients also reacted to the chemically nonrelated cincaine, an anesthetic of the ester type. The lidocaine metabolites o-toluidine and mxylidine gave negative reactions.

Type IV allergy to amide‐type local anesthetics

“…Since the 1940s, only 18 patients have been reported with symptoms and test results suggestive of Type IV allergy (3). Among these, sensitization to more than one amide-type anesthetic was observed in 4 cases (3)(4)(5). In our as well as in these cases, cross-sensitization is the most likely reason.…”

Allergic contact dermatitis from prilocaine, one of the local anaesthetics in EMLA® cream

“…Prilocaine has been used as a local anaesthetic since 1961 and is usually considered to be safe (2). The I st case of hypersensitivity to prilocaine was reported in 1971; to our knowlegde, only 6 additional reports have appeared in the literature, only 3 of which being confirmed by positive patch tests (2)(3)(4). These patients had not been submitted to previous exposure to prilocaine, but were known to be allergic to lidocaine.…”

Delayed-Type Hypersensitivity to Lidocaine

“…The most commonly reported cause of allergic contact dermatitis to lidocaine is through the use of antihemorrhoidal preparations. [9][10][11][12][13][14][15][16] Kernekamp and Van Ketel 17 reported a patient with an arterial leg ulcer, who, having been treated for the associated pain with gauze soaked in 5% lidocaine, developed "eczema" at the site of the applied gauze. The patch test result to 2% lidocaine was positive.…”