title: Identifying and Managing Local Anesthetic Allergy in Dermatologic Surgery.
abstract: BACKGROUND
  Local anesthetic (LA) allergy is a concern for dermatologic surgeons given the large number of procedures performed yearly with LAs. Many patients also have anxiety about past or potential anesthesia allergy.
  
  
  OBJECTIVE
  This article will review the symptoms of IgE-mediated allergic reactions, the prevalence of IgE-mediated LA allergy, discuss common mimics of LA, and propose a practical approach for diagnostic and therapeutic options for LA allergy for the dermatologic surgeon in practice.
  
  
  METHODS
  A literature search of Pubmed using keywords "lidocaine," "local anesthetic," "hypersensitivity," and "allergy" was performed.
  
  
  RESULTS
  Amide anesthetics result in the most reports of true local anesthetic immediate hypersensitivity.
  
  
  CONCLUSIONS
  True IgE-mediated anaphylaxis to local anesthesia is very rare. Dermatologic surgeons should be aware of the symptoms of anesthetic allergy and its mimickers, as well as how to manage allergic reactions in their clinical practice.
authors.affiliation: Department of Dermatology, University of Colorado School of Medicine, Aurora, Colorado.
authors.forename: Ramin
authors.initials: R
authors.lastname: Fathi
authors.forename: Marc
authors.initials: M
authors.lastname: Serota
authors.forename: Mariah
authors.initials: M
authors.lastname: Brown
mesh_terms: D000779:Anesthetics, Local / Q000009:adverse effects*; D062109:Dermatologic Surgical Procedures; D004342:Drug Hypersensitivity / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000276:immunology; D004837:Epinephrine / Q000627:therapeutic use; D006633:Histamine Antagonists / Q000627:therapeutic use; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D013566:Sympathomimetics / Q000627:therapeutic use
chemical_list: D000779:Anesthetics, Local; D006633:Histamine Antagonists; D013566:Sympathomimetics; D007073:Immunoglobulin E; D004837:Epinephrine