Prescription and over-the-counter topical anesthetics are commonly used. Although allergy to amide and ester anesthetics is known, little has been reported on the nonamide, nonester pramoxine (pramocaine). This article briefly reviews allergy to topical anesthetics, provides detailed information on pramoxine, and describes characteristics of multiple patients with positive, relevant reactions to pramoxine.
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References
1.
PatelN, SadoughiA.Pharmacology of local anesthetics. In: KayeA, KayeA, UrmanR, eds. Essentials of Pharmacology for Anesthesia, Pain Medicine, and Critical Care. New York, NY: In, Springer; 2015:179–194.
2.
BorenE, TeuberSS, NaguwaSM, et al.A critical review of local anesthetic sensitivity. Clin Rev Allergy Immunol, 2007; 32(1):119–127.
3.
CalderonAL, DiotN, BenatirF, et al.Immediate allergic cross-reactivity to levobupivacaine and ropivacaine. Anaesthesia, 2013; 68:203–205.
4.
ThyssenJP, MennéT, ElberlingJ, et al.Hypersensitivity to local anaesthetics—update and proposal of evaluation algorithm. Contact Dermatitis, 2008; 59(2):69–78.
KlerisRS, KeswaniA, LugarP. The eyes have it: eyelid swelling and rash in a 79-year-old woman with macular degeneration. Allergy Rhinol (Providence), 2018; 9:2152656718763385.
7.
SoongWJ, LeeYS, SoongYH, et al.Life-threatening anaphylactic reaction after the administration of airway topical lidocaine. Pediatr Pulmonol, 2011; 46:505–508.
GilissenL, GoossensA. Frequency and trends of contact allergy to and iatrogenic contact dermatitis caused by topical drugs over a 25-year period. Contact Dermatitis, 2016; 75(5):290–302.
10.
WarshawEM, SchramSE, BelsitoDV, et al.Patch test reactions to topical anesthetics: retrospective analysis of cross-sectional data from the North American Contact Dermatitis Group 2001–2004. Dermatitis, 2007; 18(2):118–119.
11.
BhatiaN, LammintaustaK. Sources of sensitization, cross-reactions, and occupational sensitization to topical anaesthetics among general dermatology patients. Contact Dermatitis, 2009; 60(3):150–154.
12.
KimyonRS, SchlarbaumJP, LiouYL, et al.Allergic contact dermatitis to dyclonine (dyclocaine). Dermatitis, 2019; 30(6):372–373.
13.
SpringS, PrattM, ChaplinA. Contact dermatitis to topical medicaments: a retrospective chart review from the Ottawa Hospital Patch Test Clinic. Dermatitis, 2012; 23(5):210–213.
14.
HughesJDM, PrattMD. Allergic contact dermatitis and autoeczematization to Proctosedyl® cream and Proctomyxin® cream. Case Rep Dermatol, 2018; 10(3):238–246.
15.
SchatzM.Allergic reactions to local anesthetics. In: PostTW, ed. UpToDate. Waltham, MA: UpToDate Inc.; 2018. Available at: http://www.uptodate.com. Accessed June21, 2019.
16.
PurcellSM, DixonSL. Allergic contact dermatitis to dyclonine hydrochloride simulating extensive herpes simplex labialis. J Am Acad Dermatol, 1985; 12(2):231–234.
van KetelWG.Allergy to pramoxine (pramocaine). Contact Dermatitis, 1981; 7(1):49.
19.
CusanoF, LucianoS. Contact dermatitis from pramoxine. Contact Dermatitis, 1993; 28(1):39.
20.
GarcíaF, IparraguirreA, BlancoJ, et al.Contact dermatitis from prilocaine with cross-sensitivity to pramocaine and bupivacaine. Contact Dermatitis, 2007; 56(2):120–121.
21.
HylwaSA, WarshawE. Contact allergy to pramoxine (pramocaine): the importance of testing to personal products. Dermatitis, 2014; 25(3):147–148.
22.
SchlarbaumJP, KimyonRS, LiouYL, et al.Genital dermatitis in a transgender patient returning from Thailand: a diagnostic challenge. Travel Med Infect Dis, 2019; 27:134–135.
