title: Delayed-type hypersensitivity to subcutaneous lidocaine with tolerance to articaine: confirmation by in vivo and in vitro tests.
abstract: A 43-year-old woman suffered from recurrent localized swellings and an eczematous dermatitis starting 1 day after an injection of lidocaine. Intradermal patch and lymphocyte transformation tests revealed sensitization to lidocaine and cross-reactivity to the other aminoacylamide local anesthetics bupivacaine, mepivacaine and prilocaine, but not to articane. Contact allergy to the ester local anesthetics benzocaine, procaine and tetracaine, the quinoline or aminoacylamide cinchocaine, and the preservatives methylparaben and metabisulfite, was excluded. A subcutaneous challenge with articaine was well tolerated.
authors.affiliation: Department of Dermatology, University Hospital, Basel, Switzerland.
authors.forename: A J
authors.initials: AJ
authors.lastname: Bircher
authors.forename: S L
authors.initials: SL
authors.lastname: Messmer
authors.forename: C
authors.initials: C
authors.lastname: Surber
authors.forename: T
authors.initials: T
authors.lastname: Rufli
mesh_terms: D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects*; D001566:Benzocaine / Q000008:administration & dosage; D002045:Bupivacaine / Q000009:adverse effects; D002355:Carticaine / Q000008:administration & dosage*; D003429:Cross Reactions; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis; D003992:Dibucaine / Q000008:administration & dosage; D003875:Drug Eruptions / Q000209:etiology*; D004361:Drug Tolerance; D004485:Eczema / Q000139:chemically induced; D004487:Edema / Q000139:chemically induced; D005260:Female; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000139:chemically induced*; D007279:Injections, Subcutaneous; D008012:Lidocaine / Q000008:administration & dosage / Q000009:adverse effects*; D008213:Lymphocyte Activation / Q000187:drug effects; D008619:Mepivacaine / Q000009:adverse effects; D010226:Parabens / Q000008:administration & dosage; D010328:Patch Tests; D011310:Preservatives, Pharmaceutical / Q000008:administration & dosage; D011318:Prilocaine / Q000009:adverse effects; D011343:Procaine / Q000008:administration & dosage; D011804:Quinolines / Q000008:administration & dosage; D012008:Recurrence; D012882:Skin Tests; D013447:Sulfites / Q000008:administration & dosage; D013748:Tetracaine / Q000008:administration & dosage
chemical_list: D000779:Anesthetics, Local; D010226:Parabens; D011310:Preservatives, Pharmaceutical; D011804:Quinolines; D013447:Sulfites; D011318:Prilocaine; D013748:Tetracaine; D011343:Procaine; C030981:metabisulfite; D008012:Lidocaine; C015358:methylparaben; D008619:Mepivacaine; D002355:Carticaine; C037219:quinoline; D003992:Dibucaine; D001566:Benzocaine; D002045:Bupivacaine