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Related Concept Videos

Allergic Drug Reactions01:27

Allergic Drug Reactions

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Allergic reactions related to drugs are hypersensitivity responses driven by the immune system and bear no connection to the drug's therapeutic action. While drugs in isolation do not trigger an immune response, they can interact with endogenous proteins to form antigens. These antigens stimulate lymphocytes to produce antibodies. IgE-type antibodies attach themselves to mast cells. Upon subsequent exposure to the same stimulus, the antigen-antibody interaction is initiated, unleashing...
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Local Anesthetics: Differential Sensitivity of Nerve Fibers01:24

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Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
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Local Anesthetics: Adverse Effects01:12

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While local anesthetics are generally safe and well-tolerated, they can occasionally cause adverse effects that vary in severity. Local anesthetics can induce toxicity at two distinct levels. They can either produce local effects through direct contact with the neural elements or be absorbed into the bloodstream from the injection site, leading to systemic effects.
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...
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Drug Toxicity: Allergic Reactions01:30

Drug Toxicity: Allergic Reactions

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Drug-related allergies are immune-mediated responses triggered by the administration of pharmacological agents. These hypersensitivity reactions are classified based on the immune mechanisms involved. The four primary types—Type I, II, III, and IV—are mediated by different immunological pathways and exhibit distinct clinical manifestations.Type I Hypersensitivity/ IgE-Mediated Reactions: Immunoglobulin E (IgE) immediately mediates Type I hypersensitivity reactions. Upon initial...
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Allergic Reactions: Anaphylaxis01:30

Allergic Reactions: Anaphylaxis

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Anaphylaxis is a severe, life-threatening hypersensitivity reaction mediated by Immunoglobulin E (IgE) antibodies. When IgE binds to allergens, it triggers the release of mediators– histamine, leukotrienes, and prostaglandins from mast cells and basophils. These mediators cause vasodilation, edema, and inflammation, leading to various symptoms.The primary allergens causing anaphylaxis include food items (e.g., peanuts, shellfish), drugs (e.g., penicillin, asparaginase, corticotropin,...
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Allergic Reactions02:06

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Updated: Mar 24, 2026

Precision Implementation of Minimal Erythema Dose MED Testing to Assess Individual Variation in Human Inflammatory Response
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Lidocaine Allergy: Do Positive Patch Results Restrict Future Use?

Michael Domenic Corbo1, Elizabeth Weber, Joel DeKoven

  • 1From the *Division of Dermatology, Department of Medicine, Sunnybrook Health Sciences Centre; †Division of Clinical Immunology and Pharmacology, Department of Medicine, University of Toronto; and ‡Department of Occupational and Environmental Health, St. Michael's Hospital, Toronto, Ontario, Canada.

Dermatitis : Contact, Atopic, Occupational, Drug
|March 17, 2016
PubMed
Summary

Suspected lidocaine allergy in patients can be investigated with skin testing. Positive patch tests to lidocaine, with negative intradermal and subcutaneous challenge results, suggest safe future use of injectable lidocaine.

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Area of Science:

  • Dermatology
  • Allergology
  • Pharmacology

Background:

  • Adverse reactions to lidocaine are frequently reported, necessitating allergy investigation.
  • Skin testing is crucial for confirming suspected lidocaine allergy and its clinical relevance.

Purpose of the Study:

  • To evaluate 13 cases of suspected lidocaine allergy.
  • To determine if positive patch test results for lidocaine impact its future use as an injectable local anesthetic.

Main Methods:

  • Prospective study conducted in two academic hospital-based patch test clinics.
  • Patients underwent standard North American Contact Dermatitis Group series and local anesthetic series patch testing.
  • Lidocaine-positive patients received intradermal testing followed by subcutaneous challenge if results were negative.

Main Results:

  • 13 out of 756 patients (1.7%) showed positive patch tests to lidocaine.
  • Reactions varied: 7 to over-the-counter products, 2 to subcutaneous lidocaine, 4 incidental findings.
  • No positive intradermal tests; 3 delayed reactions occurred during subcutaneous challenge.

Conclusions:

  • Patients with positive lidocaine patch tests but negative intradermal and subcutaneous challenge results can likely use injectable lidocaine safely.
  • Skin testing protocols help differentiate true allergy from other reactions, guiding safe anesthetic use.