Delayed-type hypersensitivity to subcutaneous lidocaine with tolerance to articaine: Confirmation by in vivo and in vitro tests

A 43-year-old woman suffered from recurrent localized swellings and an eczematous dermatitis starting 1 day after an injection of lidocaine. Intradermal, patch and lymphocyte transformation tests revealed sensitization to lidocaine and cross-reactivity to the other aminoacylamide local anesthetics bupivacaine, mepivacaine and prilocaine, but not to articaine. Contact allergy to the ester local anesthetics benzocaine, procaine and tetracaine, the quinoline or aminoalkylamide cinchocaine, and the preservatives methylparaben and metabisulfite, was excluded. A subcutaneous challenge with articaine was well tolerated. (C) Munksgaard, 1996.