Contact sensitivity to multiple local anesthetics

Redfern, David

doi:10.1016/s0091-6749(99)70305-2

Cited by 21 publications

(8 citation statements)

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“…Was this co‐sensitization or 2 isolated cases of cross‐reactions between amide LA and ester LA? We note that cross‐reactions between amide LA with cycle on ionizable group (mepivacaine and bupivacaine) and amide without cycle on ionizable group have been observed (5, 12–15, 17). Consequently, the structure of the ionizable group cannot predict a cross‐reaction.…”

Section: Discussionmentioning

confidence: 94%

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Contact urticaria from Emla^® cream

et al. 2004

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We report the first case of immediate-type hypersensitivity caused by Emla cream. A 55-year-old woman, after using Emla cream, went on to develop urticaria. An open test was positive to Emla cream. Patch tests and prick tests were performed with Emla cream, the components of Emla cream (lidocaine, prilocaine and castor oil) and other local anaesthetics. The patch test with lidocaine and the prick test with Emla cream were both positive. An intradermal test and subcutaneous administration of 3 anaesthetics that had negative patch tests and prick tests were performed and well tolerated, allowing their use. In the literature, anaphylactic reactions to lidocaine injections, delayed-type hypersensitivity after lidocaine subcutaneous injections and contact dermatitis from Emla cream have all been described. This first case of contact urticaria from Emla cream was due to lidocaine and did not show any cross-reaction with other local anaesthetics.

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Section: Discussionmentioning

confidence: 94%

“…Hardwick and King (13) had a patient sensitized to lidocaine and bupivacaine. Redfern and Waterloo (14) had 1 case of allergy to lidocaine, mepivacaine and ropivacaine. Van Ketel (15) reported 1 case of a reaction to lidocaine, prilocaine and mepivacaine.…”

Section: Discussionmentioning

confidence: 99%

Contact urticaria from Emla^® cream

et al. 2004

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“…IgE-mediated reactions are usually characterized by urticaria, angioedema, wheezing, and shock. When used topically, LA can provoke contact dermatitis in type IV Gell-Coombs mechanism [8]. The vast majority of unwanted reactions is nonimmunologic, and their clinical manifestation is usually mild.…”

Section: Discussionmentioning

confidence: 99%

The Negative Predictive Value of Typing Safe Local Anesthetics

Specjalski

Kita-Milczarska²,

Jassem³

2013

Int Arch Allergy Immunol

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Background: Although allergy to local anesthetics (LA) is rare, patients often report unwanted reactions after their administration. A history of anaphylaxis or an atypical reaction related to LA is an indication for typing a safe anesthetic for future surgical or dental procedures. Aim: The aim of the study was to determine the negative predictive value (NPV) of typing safe LA. Methods: A total of 154 patients with a history of an unwanted reaction to LA were enrolled into the study. Stepwise typing of a safe anesthetic included skin prick tests (SPT) and intracutaneous tests (ICT) with two or three of the following LA: lidocaine, bupivacaine, mepivacaine, and articaine. Skin tests were followed by provocations with one or two LA. Telephone follow-up visits were performed 4-12 months after drug typing. On the basis of follow-up questionnaire results, the NPV of the protocol was calculated. Results: The full protocol was performed in 148 patients. Positive results of SPT were observed in 2, of ICT in 19 and of provocations in 11 cases. Lidocaine was found safe in 44, bupivacaine in 14, mepivacaine in 34 and articaine in 61 patients. The drug typed at the clinical visit was administered in 78 patients, and 76 reported no reactions (NPV = 97%). Conclusion: Stepwise approach including SPT, ICT and provocations is safe and allows typing a safe anesthetic in a vast majority of patients.

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“…Our report emphasizes the importance of patch testing in tracking down the allergen under such conditions. Furthermore, patch testing can exclude other potential sensitizers in a medicament, other allergens, such as thiuram (3), or cross‐sensitizations to other local anaesthetics (4).…”

Section: Discussionmentioning

confidence: 99%

Allergic contact dermatitis from benzocaine ointment during treatment of herpes zoster

Roos¹

2001

Contact Dermatitis

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Contact sensitivity to multiple local anesthetics

Cited by 21 publications

References 0 publications

Contact urticaria from Emla^® cream

Contact urticaria from Emla^® cream

The Negative Predictive Value of Typing Safe Local Anesthetics

Allergic contact dermatitis from benzocaine ointment during treatment of herpes zoster

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Contact sensitivity to multiple local anesthetics

Cited by 21 publications

References 0 publications

Contact urticaria from Emla® cream

Contact urticaria from Emla® cream

The Negative Predictive Value of Typing Safe Local Anesthetics

Allergic contact dermatitis from benzocaine ointment during treatment of herpes zoster

Contact Info

Product

Resources

About

Contact urticaria from Emla^® cream

Contact urticaria from Emla^® cream