Vascular effects of a local anesthetic mixture in atopic dermatitis

An anesthetic cream with an eutectic mixture of 5% lidocaine and 5% prilocaine has been tested on the skin of healthy subjects and patients with atopic dermatitis and generalized eczema. In healthy subjects a blanching was seen when the analgesia was complete after 30-60 min. In the dry skin and eczematous lesions of atopic dermatitis an application time of 5-15 min caused a blanching and a good analgesia. When applied for 30-60 min the eczematous skin became increasingly red and in one patient purpura appeared. The white dermographism turned red in treated areas. The abnormal vascular reactions to the cream in diseased skin can be explained by a rapid and increased percutaneous absorption of the anesthetics. A shortened application time is here recommended.