IngentaConnect Hypersensitivity to local anaesthetics update and proposal of eva...

Authors: Thyssen, JacobPontoppidan; Menné, Torkil¹; Elberling, Jesper²; Plaschke, Peter³; Johansen, JeanneDuus⁴

Source: Contact Dermatitis, Volume 59, Number 2, August 2008 , pp. 69-78(10)

Abstract:

Local anaesthetics (LA) are widely used drugs. Adverse reactions are rare but may be caused by delayed-type hypersensitivity reactions and probably also immediate-type reactions. As it is not always easy to clinically differ between these subtypes, allergy skin testing should be considered. Although numerous test protocols have been published, how patients with hypersensitivity reactions to LA are ideally evaluated remains a topic of discussion. This review attempts to generate a comprehensive update on allergic reactions to LA and to present an algorithm that can be used for the evaluation of patients suspected with immediate- and delayed-type immune reactions. Literature was examined using PubMed-Medline, EMBASE, Biosis and Science Citation Index. Based on the literature, the proposed algorithm may safely and rapidly distinguish between immediate-type and delayed-type allergic immune reactions.

Keywords: allergy; contact allergy; lidocaine; local anaesthetics; treatment; type 1; type 4

Document Type: Research article

DOI: 10.1111/j.1600-0536.2008.01366.x

Affiliations: 1: Department of Dermatology 2: Department of Dermatology, The Danish Research Centre for Chemical Sensitivities 3: Department of Pulmonary Medicine, Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark 4: Department of Dermatology, National Allergy Research Centre

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Hypersensitivity to local anaesthetics - update and proposal of evaluation algorithm