Allergy Asthma Respir Dis.  2014 Sep;2(4):298-301. 10.4168/aard.2014.2.4.298.

Delayed urticaria caused by lidocaine in a child

• Park GM
• Han HW
• Kim JY
• Hwang KH
• Lee E
• Yang SI
• Jung YH
• Hong SJ
• Seo JH
• Yu J

• KMID: 2262399
• DOI: http://doi.org/10.4168/aard.2014.2.4.298

Abstract

Lidocaine is a commonly used local anesthetic for dental treatment. Urticaria caused by lidocaine has seldom been reported. Generally, urticaria immediately develops after exposure to a causative agent and is considered a manifestation of IgE-mediated hypersensitivity. However, delayed urticaria caused by local anesthetics was reported to be related to cell mediated hypersenstivity. A 3-year old girl visited our allergy clinic due to delayed urticaria after local administration of lidocaine. Both skin prick and intradermal tests with lidocaine revealed negative reactions. However, the provocation test with subcutaneous injection of lidocaine showed urticaria 7 hours after test. In order to identify alternative local anesthetic for the subsequent dental procedure, we performed skin prick, intradermal and provocation tests with procaine, a local anesthetic of the other class, all of which showed negative results. Therefore, we recommended procaine as an alternative local anesthetic, and the patient was successfully treated with procaine. To the best of our knowledge, this is the first case of delayed urticaria caused by lidocaine in Korea.

Keyword

Lidocaine; Local anesthetic; Urticaria; Adverse drug reaction

MeSH Terms

Anesthetics, Local
Child*
Drug-Related Side Effects and Adverse Reactions
Female
Humans
Hypersensitivity
Hypersensitivity, Immediate
Injections, Subcutaneous
Intradermal Tests
Korea
Lidocaine*
Procaine
Skin
Urticaria*
Anesthetics, Local
Lidocaine
Procaine

Reference

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