Department of Dermatology, Coimbra University Hospital, 3000-075 Coimbra, Portugal.
Contact Dermatitis. 2013 Mar;68(3):156-62. doi: 10.1111/j.1600-0536.2012.02149.x. Epub 2012 Jul 19.
Contact allergy to local anaesthetics is relatively common. Patch testing with benzocaine in the European baseline series is recommended for diagnosis, even though a caine mix has been previously suggested to be superior.
To assess the frequency and patterns of contact allergy to local anaesthetics by using a caine mix (benzocaine, tetracaine, and cinchocaine) in the baseline series, and evaluate its efficiency as compared with benzocaine alone.
We reviewed the results of 2736 patch tests performed between 2000 and 2010, identifying patients with positive reactions to caine mix or to one of seven local anaesthetics.
One hundred and twelve patients (4.1%) had at least one allergic reaction to local anaesthetics; 86 were tested with all seven local anaesthetics, resulting in 71 reactions in 53 patients. Cinchocaine gave the most reactions (50.7%); these occurred as a single reaction in 83.3% of patients, mostly with current or past relevance (97%). Benzocaine represented 22.5% of reactions, many of which were non-relevant (44%) or resulting from cross-reactions with para-compounds.
Almost 70% of allergic reactions to local anaesthetics would have been missed if benzocaine had been used as a screening allergen. This study supports a recommendation to replace benzocaine with a caine mix containing cinchocaine in the baseline patch test series.
局部麻醉剂过敏相对常见。欧洲基础系列推荐使用苯佐卡因进行斑贴试验诊断，尽管此前曾建议使用卡因混合物更好。
使用基础系列中的卡因混合物（苯佐卡因、四卡因和辛可卡因）评估局部麻醉剂接触过敏的频率和模式，并评估其与苯佐卡因单独使用的效率。
我们回顾了 2000 年至 2010 年间进行的 2736 次斑贴试验的结果，确定了对卡因混合物或七种局部麻醉剂中的一种有阳性反应的患者。
112 名患者（4.1%）对局部麻醉剂至少有一次过敏反应；86 名患者接受了所有七种局部麻醉剂的测试，结果在 53 名患者中出现 71 次反应。辛可卡因引起的反应最多（50.7%）；这些反应在 83.3%的患者中是单次反应，大多数与当前或过去的相关性（97%）有关。苯佐卡因占反应的 22.5%，其中许多是不相关的（44%）或与对位化合物的交叉反应有关。
如果苯佐卡因作为筛查变应原，将近 70%的局部麻醉剂过敏反应将被遗漏。本研究支持建议在基础斑贴试验系列中用含有辛可卡因的卡因混合物代替苯佐卡因。
