Simultaneous erythema nodosum and erythema multiforme after local lidocaine injection.
OBJECTIVE
To report a case of simultaneous erythema nodosum and erythema multiforme after local lidocaine injection.


METHODS
A 33-year-old female experienced coexisting erythema nodosum and erythema multiforme after lidocaine spray was used for upper gastrointestinal endoscopy. The reaction was exacerbated after localized injection of 2% lidocaine for a skin biopsy. An objective causality assessment revealed that an adverse drug reaction was highly probable.


CONCLUSIONS
Lidocaine is the most frequently used local anesthetic agent. The coexistence of erythema nodosum and erythema multiforme has been reported in lepromatous leprosy, Yersinia enterocolítica and Yersinia pseudotuberculosis gastrointestinal infection (both with diarrhea), histoplasmosis, hepatitis C, and milkeŕs nodule, but not with lidocaine.


CONCLUSIONS
If clinicians observe similar lesions after lidocaine exposure, they should suspect an adverse drug reaction and exercise caution in the administration of amide anesthetics to patients with a documented history of adverse reaction to lidocaine.
Rodríguez-Carreón
Alma Angélica
AA
Dermatology, General Hospital Dr. Manuel Gea González, Mexico City, Mexico.
Vega-Memije
Elisa
E
Moreno-Coutiño
Gabriela
G
López-García
Lirio
L
Domínguez-Cherit
Judith
J
Arenas
Roberto
R
D000287:Administration, Topical; D000328:Adult; D000779:Anesthetics, Local / Q000009:adverse effects*; D001706:Biopsy; D016099:Endoscopy, Gastrointestinal; D004892:Erythema Multiforme / Q000139:chemically induced*; D004893:Erythema Nodosum / Q000139:chemically induced*; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000009:adverse effects*
D000779:Anesthetics, Local; D008012:Lidocaine