Reactions 1091 - 4 Mar 2006

Mepivacaine

Allergic contact dermatitis: case reportA 54-year-old woman developed allergic contact dermatitis

from local anaesthesia with mepivacaine and she showedcross-reactivity to lidocaine. She had no history of atopy orallergy.

Seven years earlier, the woman had undergone a secondsession of sclerotherapy on her legs with polidocanol andmepivacaine [dosage not stated]. Two days later, shedeveloped pruritus and a maculopapular rash on her legs.[Patient outcome not stated.] She underwent her next sessionsof sclerotherapy without mepivacaine, and they were toleratedwell. Six months later, she received a mepivacaine 2% injection[dosage not stated] for surgery and, 2 days later, developed asimilar eruption at the injection site; this eruption completelyresolved in 7 days without treatment.

Skin prick and intradermal tests were performed withmepivacaine 1%, lidocaine 2%, bupivacaine and articaine.Only the intradermal skin test with mepivacaine was positiveafter 48 hours. Patch testing was positive for mepivacaine 1%,2% and 3%, and for lidocaine 2%, 5% and 10%, but wasnegative for bupivacaine, articaine and ropivacaine. A skinbiopsy from a positive mepivacaine patch test revealedhyperkeratosis, dermal fibrosis and a lymphocytic infiltrate.Subcutaneous challenges with bupivacaine and articaine werenegative, so these two medications were recommended aslocal anaesthetics suitable for future use.Sanchez-Morillas L, et al. Delayed-type hypersensitivity to mepivacaine withcross-reaction to lidocaine. Contact Dermatitis 53: 352-353, No. 6, Dec 2005 -Spain 801031511

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Reactions 4 Mar 2006 No. 10910114-9954/10/1091-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved