title: Allergy to lidocaine injections: comparison of patient history with skin testing in five patients.
abstract: BACKGROUND
  True allergy to local anesthetics, especially lidocaine, is uncommon. Most adverse reactions to this group of medications are classified as psychomotor, autonomic or toxic. In the case of suspected hypersensitivity to local anesthetics, skin testing is considered to be a useful tool - patch tests and intradermal tests for delayed hypersensitivity and skin prick tests and intradermal tests for immediate reactions. There is a particular need for such a diagnostic procedure, as patients suspected of hypersensitivity to local anesthetic drugs are frequently admitted.
  
  
  OBJECTIVE
  To highlight the problem of hypersensitivity to local anesthetics on the basis of authors' own experience and literature data.
  
  
  METHODS
  We present cases of 5 patients referred to the clinic by their dentists with a suspicion of allergy to local anesthetics, four to lidocaine and 1 to articaine.
  
  
  RESULTS
  Intradermal tests were positive in 1 out of 5 subjects, with a concomitant episode of urticaria. In 1 patient we obtained a doubtful result of intradermal tests. Skin prick tests and patch tests were negative in all cases. In 2 cases we performed an incremental challenge test also with a negative result.
  
  
  CONCLUSIONS
  It has to be emphasized that, although rare, consequences of true allergy to local anesthetics can be serious considering a patient's future management and therapy. That is why this diagnosis may be crucial.
authors.affiliation: Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland. Head of Department: Prof. Zbigniew Adamski MD, PhD.
authors.forename: Dorota
authors.initials: D
authors.lastname: Jenerowicz
authors.affiliation: Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland. Head of Department: Prof. Zbigniew Adamski MD, PhD.
authors.forename: Adriana
authors.initials: A
authors.lastname: Polańska
authors.affiliation: Department of Dermatology, Medical University of Warsaw, Poland. Head of Department: Prof. Lidia Rudnicka MD, PhD.
authors.forename: Olga
authors.initials: O
authors.lastname: Glińska
authors.affiliation: Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland. Head of Department: Prof. Zbigniew Adamski MD, PhD.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Czarnecka-Operacz
authors.affiliation: Dermatology and Pathology, New Jersey Medical School, Newark, New Jersey, USA. Head of Dermatology: Prof. Robert A. Schwartz MD, MPH.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Schwartz
keywords: incremental challenge test; lidocaine; skin tests
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