cqvip:We report the first case of immediate-type hypersensitivity caused by Emla. c ream. A 55-year-old woman, after using Emlacream, went on to develop urticar ia. An open test was positive to Emlacream. Patch tests and prick tests were p erformed with Emlacream, the components of Emlacream (lidocaine, prilocaine and castor oil) and other local anaesthetic s. The patch test with lidocaine and the prick test with Emlacream were both p ositive. An intradermal test and subcutaneous administration of 3 anaesthetics t hat had negative patch tests and prick tests were performed and well tolerated,a llowing their use. In the literature, anaphylactic reactions to lidocaine inject ions, delayed-type hypersensitivity after lidocaine subcutaneous injections and contact dermatitis from Emlacream have all been described. This first case of contact urticaria from Emlacream was due to lidocaine and did not show any cr oss-reaction with other local anaesthetics.
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