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Correspondence |

Localized Contact Urticaria Caused by Lidocaine/Tetracaine Peel

Jennifer Channual, BS; Jashin J. Wu, MD; Christopher B. Zachary, MBBS, FRCP
Arch Dermatol. 2009;145(4):499-500. doi:10.1001/archdermatol.2009.56.
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The lidocaine, 7%/tetracaine, 7%, cream Pliaglis (Galderma Laboratories, Fort Worth, Texas) (hereinafter, “LT peel”) is a novel topical anesthetic cream that forms a self-occlusive, pliable membrane on exposure to air. The LT peel has been shown to be a safe and effective form of local anesthesia for various dermatologic procedures.1 Minimal adverse effects associated with the LT peel have been reported, limited primarily to transient skin erythema with or without skin discoloration or edema.1 Herein, we report a case of contact urticaria and discuss possible causes of such allergic manifestations and potential hazards and precautions recommended with the use of the LT peel.

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Figure 1.

Slightly edematous, well-demarcated, erythematous plaque appearing 15 minutes after application of lidocaine, 7%/tetracaine, 7%, cream to the face. Arrows designate the margins of the plaque and correspond to the edges of the area where the cream was applied.

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Figure 2.

Well-demarcated areas of facial erythema and mild lip edema without evidence of lingual edema.

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Figure 3.

Mild lip edema occurred 15 minutes after lidocaine, 7%/tetracaine, 7%, cream was applied to the face (A) and resolved, as did the contact urticaria, within 30 minutes of treatment with a single 50-mg oral dose of diphenhydramine (B).

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