Reactions 565 - 26 Aug 1995

★Mepivacaine

First report of fixed drug eruption: case reportA 22-year-old woman experienced a fixed drug eruption on

4 occasions after she received mepivacaine injections [dosagenot stated] during oral surgery.

The eruption consisted of erythemic, pruritic lesions on thebuccal commissures and upper right eyelid. The lesionsappeared 20 minutes after administration of mepivacaine[‘Scandinibsa’] with maximum expression 24 hours later andresolution with desquamation and slight hyperpigmentation12 to 14 days later.

Intradermal tests with mepivacaine were negative, but asubsequent challenge test with SC mepivacaine 20mg resultedin the characteristic fixed drug eruption. The woman wastreated with dexchlorpheniramine and corticosteroids and herlesions resolved after 2 days.

One week later, an intradermal test with lidocaine wasnegative. One month after the mepivacaine challenge, thewoman was challenged with SC lidocaine and had no reaction.She also later tolerated lidocaine.

Author comment: ‘We believe this to be the first reportedcase of a fixed drug eruption induced by mepivacaine in apatient with good tolerance to lidocaine.’Torres MJ, et al. Fixed drug eruption induced by mepivacaine. Journal of Allergyand Clinical Immunology 96: 130-131, Jul 1995 - Spain 800383519

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Reactions 26 Aug 1995 No. 5650114-9954/10/0565-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved