Evaluation of re-challenge in patients with suspected lidocaine allergy.
BACKGROUND
Lidocaine is an anaesthetic agent used worldwide in various clinical specialties. Although lidocaine hypersensitivity is very rare, clinicians frequently encounter patients with such an alleged diagnosis. Using a questionnaire, we evaluated the results of re-challenge with lidocaine, the gold standard for assessing hypersensitivity reactions in patients who claim to be allergic to this drug.


METHODS
A detailed questionnaire was sent to members of the French Dermatological Society, targeting the management of patients claiming lidocaine intolerance. After analysis and recall of doubtful episodes, 199 re-challenges were made. True lidocaine hypersensitivity was finally demonstrated in only 1 patient.


CONCLUSIONS
The results of this study demonstrate that patients claiming to be allergic to lidocaine are usually not, their symptoms corresponding in most cases to a vasovagal episode. Re-challenge is safe and may constitute an easy and cheap alternative to skin testing. This should be performed in specialized centres except in case of a vasovagal episode.
Amsler
E
E
Service d'Allergologie, Hôpital Tenon, Paris, France. emmanuelle.amsler@ap-hop-paris.fr
Flahault
A
A
Mathelier-Fusade
P
P
Aractingi
S
S
D004342:Drug Hypersensitivity / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007279:Injections, Subcutaneous; D008012:Lidocaine / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
D008012:Lidocaine