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February 1975

Presumed Generalized Exfoliative Dermatitis to Lidocaine

Author Affiliations

Davis and San Francisco, Calif

Arch Dermatol. 1975;111(2):266. doi:10.1001/archderm.1975.01630140124022

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To the Editor.—  Since its introduction in 1948, lidocaine hydrochloride, an acetanilide derivative, has become a widely used local anesthetic because of the rarity of toxic effects. Only 11 cases of presumed hypersensitivity reactions, such as urticaria, anaphylactoid reactions, and convulsions have been published. We report a patient with generalized papulovesicular lesions leading to exfoliative dermatitis.

Report of a Case.—  A 21-year-old man was referred because of generalized papulovesicular eruption. He had no history of previous skin disease or allergy. A phenobarbital-belladonna mixture and thiamine hydrochloride capsules were the drugs he received orally recently. He had for the first time 2% lidocaine hydrochloride with epinephrine, 1:50,000, injections as a dental anesthetic the previous month.Three days after the second injection, he developed a papular pruritic eruption on his arms. A flare-up occurred one day after the third injection. This eruption became generalized the following week, but spared the palms and

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