Allergic contact dermatitis from prilocaine, one of the local anaesthetics in EMLA® cream

Contact dermatitis from prilocaine with cross‐sensitivity to pramocaine and bupivacaine

“…Few previous reports of primary contact allergy to prilocaine from EMLA have been described. These cases occurred after topical use of EMLA for an arterial ulceration (1), postherpetic neuralgia (2), haemodyalisis fistula (3), and iron subcutaneous injections (4). As in our case, these patients did not react to lidocaine.…”

Topical Anesthetics for Dermatologic Procedures: A Review

“…After 2 to 3 hours of application, a rebound vasodilation occurs that results in skin erythema, which should not be confused with other rare adverse cutaneous reactions such as contact urticaria or allergic contact dermatitis . It appears that prilocaine is the agent that plays a role in allergenicity …”

Pediatric Anesthesia in Dermatologic Surgery: When Hand-Holding is Not Enough

“…Iontophoresis of various anesthetic agents including lidocaine has also been used to administer transdermal anesthesia. Used appropriately, these methods of anesthesia may reduce or obviate the pain and discomfort of certain procedures (Table 1) 1–15 . Topical anesthetics and iontophoresis are discussed in detail by other authors in this issue (see Friedman PM, et al and Greenbaum SS).…”

“…Local effects include temporary erythema or pallor, eye irritation, edema, and allergic contact dermatitis. The prilocaine component of EMLA is the agent responsible for allergic contact dermatitis in most studies, as determined by patch testing 1–4 . There is a report of extensive corneal deepithelialization with direct exposure of the cornea to EMLA, though without permanent sequelae 5 .…”