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Delayed-type hypersensitivity to amide local anesthetics.

S Duque1, L Fernández

  • 1Allergy Unit, Hospital Sierrallana, Torrelavega, Spain. mduque@hsll.scsalud.es

Allergologia Et Immunopathologia
|August 25, 2004
PubMed
Summary
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Facial eczematous eruptions after dental procedures were linked to amide local anesthetics like lidocaine. Patch testing confirmed delayed-type hypersensitivity, with cross-reactivity to related anesthetics but not articaine.

Area of Science:

  • Dermatology
  • Allergology
  • Pharmacology

Background:

  • Local anesthetics are widely used in dentistry.
  • Amide-type local anesthetics, such as lidocaine and mepivacaine, are common choices for dental procedures.
  • Adverse reactions to local anesthetics can occur, necessitating accurate diagnosis.

Observation:

  • A 54-year-old woman developed facial eczematous eruptions following dental surgery.
  • The eruptions appeared after the administration of lidocaine and mepivacaine.

Findings:

  • Patch testing revealed delayed-type hypersensitivity to lidocaine and mepivacaine.
  • Cross-reactivity was observed with other amino acid derivatives, including prilocaine and bupivacaine.
  • Notably, there was no cross-reactivity to articaine, an alternative amide local anesthetic.

Related Experiment Videos

Implications:

  • This case highlights the potential for eczematous reactions to amide local anesthetics.
  • Identifying specific anesthetic allergies and cross-reactivity patterns is crucial for patient safety.
  • Articaine may represent a safer alternative for patients with known hypersensitivity to other amide local anesthetics.