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Updated: Jun 25, 2026

A Mouse Ear Model for Allergic Contact Dermatitis Evaluation
Published on: March 24, 2023
Sources of sensitization, cross-reactions, and occupational sensitization to topical anaesthetics among general
Liippo Jussi1, Kaija Lammintausta
1Department of Dermatology, Allergy Unit, Turku University Central Hospital, PO Box 52, 20521 Turku, Finland. jussi.liippo@utu.fi
Background:
Contact sensitization to local anaesthetics is often from topical medicaments. Occupational sensitization to topical anaesthetics may occur in certain occupations.
Objectives:
The aim of the study was to analyse the occurrence of contact sensitization to topical anaesthetics in general dermatology patients.
Patients And Methods:
Patch testing with topical anaesthetics was carried out in 620 patients. Possible sources of sensitization and the clinical histories of the patients are analysed.
Results:
Positive patch test reactions to one or more topical anaesthetics were seen in 25/620 patients. Dibucaine reactions were most common (20/25), and lidocaine sensitization was seen in two patients. Six patients had reactions to ester-type and/or amide-type anaesthetics concurrently. Local preparations for perianal conditions were the most common sensitizers. One patient had developed occupational sensitization to procaine with multiple cross-reactions and with concurrent penicillin sensitization from procaine penicillin.
Conclusions:
Dibucaine-containing perianal medicaments are the major source of contact sensitization to topical anaesthetics. Although sensitization to multiple anaesthetics can be seen, cross-reactions are possible. Contact sensitization to lidocaine is not common, and possible cross-reactions should be determined when reactions to lidocaine are seen. Occupational procaine sensitization from veterinary medicaments is a risk among animal workers.
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