title: Evaluation of re-challenge in patients with suspected lidocaine allergy.
abstract: 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.
authors.affiliation: Service d'Allergologie, Hôpital Tenon, Paris, France. emmanuelle.amsler@ap-hop-paris.fr
authors.forename: E
authors.initials: E
authors.lastname: Amsler
authors.forename: A
authors.initials: A
authors.lastname: Flahault
authors.forename: P
authors.initials: P
authors.lastname: Mathelier-Fusade
authors.forename: S
authors.initials: S
authors.lastname: Aractingi
mesh_terms: 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
chemical_list: D008012:Lidocaine