title: Hypersensitivity dermatitis following suction-assisted lipectomy: a complication of local anesthetic.
abstract: We report a case of severe dermatitis involving the abdomen and thighs following suction-assisted lipectomy of these areas wherein local anesthetic containing the preservative methylparaben was used for infiltrative anesthesia. This use of local anesthetics with epinephrine can be of value in the performance of suction-assisted lipectomy to reduce blood loss, serve as an adjunct to other intraoperative anesthetic techniques, and for postoperative analgesia. Local anesthetic solutions commonly contain additives, which serve as antioxidants and antimicrobials. The most common of these preservatives is methylparaben, which can cause delayed hypersensitivity reactions. These reactions may be neither recognized nor clinically significant in small areas of infection, whereas in large body surface infiltrative procedures, such as suction-assisted lipectomy, these reactions may be of considerable consequence. This article reviews the pathophysiology and treatment of these reactions and gives recommendations for avoiding them.
authors.affiliation: Department of Anesthesiology, University of Utah Health Sciences Center, Salt Lake City 84132.
authors.forename: P G
authors.initials: PG
authors.lastname: Fine
authors.forename: D L
authors.initials: DL
authors.lastname: Dingman
mesh_terms: D000273:Adipose Tissue / Q000601:surgery*; D000779:Anesthetics, Local / Q000009:adverse effects*; D003875:Drug Eruptions / Q000209:etiology*; D005260:Female; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000139:chemically induced*; D008875:Middle Aged; D010226:Parabens / Q000009:adverse effects*; D013396:Suction
chemical_list: D000779:Anesthetics, Local; D010226:Parabens; C015358:methylparaben