Dannaker C J, Maibach H I, Austin E
Department of Dermatology, University of California, School of Medicine, San Francisco, CA, USA.
Am J Contact Dermat. 2001 Sep;12(3):177-9. doi: 10.1053/ajcd.2001.23006.
We report 2 cases of allergic contact dermatitis (ACD) to proparacaine and tetracaine. Patient 1 is an ophthalmologist with chronic finger pad dermatitis sensitized to the topical anesthetic proparacaine. Despite discontinuance of proparacaine and substitution with a patch test negative agent, tetracaine, his hand dermatitis persisted. Follow up patch testing documented that acquisition of contact allergy to tetracaine as well as thiuram had taken place. Patient 2 had a periocular eczematous dermatitis with ACD to both proparacaine and tetracaine. Cross sensitization between related topical ophthalmologic anesthetics has been suggested to be a rare occurrence. We suggest that allergic sensitization and possible cross-reaction to topical anesthetics in ophthalmologists and ophthalmologic technicians is an occupational hazard. Chronically eczematized skin might result in increased exposure to contact allergens and result in concomitant allergic sensitization. ACD to topical anesthetic agents among ophthalmologists should be recognized as a potential hazard.
我们报告了2例对丙美卡因和丁卡因发生过敏性接触性皮炎（ACD）的病例。病例1是一名眼科医生，患有慢性指腹皮炎，对局部麻醉剂丙美卡因过敏。尽管停用了丙美卡因并换用了斑贴试验阴性的药物丁卡因，但他手部的皮炎仍持续存在。后续的斑贴试验证明，他对丁卡因以及秋兰姆也发生了接触性过敏。病例2患有眼周湿疹性皮炎，对丙美卡因和丁卡因均发生了ACD。相关的局部眼科麻醉剂之间的交叉致敏被认为是罕见的情况。我们认为，眼科医生和眼科技术人员对局部麻醉剂的过敏性致敏和可能的交叉反应是一种职业危害。长期湿疹化的皮肤可能会导致接触过敏原的暴露增加，并导致伴随的过敏性致敏。眼科医生中对局部麻醉剂的ACD应被视为一种潜在危害。
