EMLA cream-induced irritant contact dermatitis.
BACKGROUND
The Eutectic Mixture of Local Anesthetics (EMLA cream) is a topical anesthetic used for providing pain relief in patients undergoing superficial surgical procedures. Cutaneous side-effects have been reported rarely.


METHODS
We present a case of irritant contact dermatitis induced by EMLA cream in a 6-year-old boy with Wiskott-Aldrich syndrome. Our patient showed clinically a well circumscribed patch corresponding to the site of application of the topical anesthetic. Histopathology showed confluent necrosis of keratinocytes in the upper epidermis, a mixed inflammatory infiltrate with priminent neutrophils in the upper dermis, and focal signs of interface changes including basal cell vacuolization and subepidermal cleft formation.


CONCLUSIONS
Graft-vs.-host-disease (GVHD), necrolytic migratory erythema, dermatitis enteropathica and pellagra should be considered in the histopathologic differential diagnosis of acute contact dermatitis caused by EMLA.
Dong
Huiting
H
Department of Dermatology, The First Teaching Hospital, Medical University of Henan, Public Republic of China.
Kerl
Helmut
H
Cerroni
Lorenzo
L
D000169:Acrodermatitis; D000287:Administration, Topical; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects*; D002648:Child; D003877:Dermatitis, Contact / Q000209:etiology* / Q000473:pathology; D003937:Diagnosis, Differential; D003875:Drug Eruptions / Q000175:diagnosis; D004890:Erythema / Q000175:diagnosis; D006086:Graft vs Host Disease / Q000175:diagnosis; D006801:Humans; D007509:Irritants / Q000009:adverse effects*; D015603:Keratinocytes / Q000187:drug effects / Q000473:pathology; D008012:Lidocaine / Q000008:administration & dosage / Q000009:adverse effects*; D000077442:Lidocaine, Prilocaine Drug Combination; D008297:Male; D009336:Necrosis; D010383:Pellagra / Q000139:chemically induced; D011318:Prilocaine / Q000008:administration & dosage / Q000009:adverse effects*
D000779:Anesthetics, Local; D007509:Irritants; D000077442:Lidocaine, Prilocaine Drug Combination; D011318:Prilocaine; D008012:Lidocaine