Allergic contact dermatitis from EMLA cream in a hemodialyzed patient

The eutectic mixture EMLA cream has many medical uses, including pain relief for hemodialyzed patients prior to cannulation. Cutaneous side effects associated with its application have rarely been reported. A patient on hemodialysis developed an itchy eruption over his brachial arteriovenous fistula, where he was applying EMLA cream three times per week, prior to puncture for hemodialysis. Patch testing elicited a positive reaction to several allergens, including EMLA cream "as is" and prilocaine. The lesions resolved after topical treatment with corticosteroids.