Contact Allergy to Lidocaine: A Report of Sixteen Cases
Bibliographic record
Abstract
Lidocaine is used widely as an injectable local anesthetic, occasionally as an intravenous drug for cardiac arrhythmias, and increasingly as a topical anesthetic. Reports of allergic contact dermatitis and delayed hypersensitivity reactions to this "amide" anesthetic are limited. We report 16 cases of lidocaine contact allergy seen over 5 years. Concomitant patch-test reactions occurred with neomycin 20% (10 cases), bacitracin 20% (9 cases), fragrance mix 8% (3 cases), balsam of Peru 25% (2 cases), and dibucaine 2.5% and benzocaine 5% (1 case each). Patch tests with lidocaine dilutions (in petrolatum) gave the following results: 10% (3 of 4 positive reactions), 5% (4 of 6 positive reactions), and 1% (3 of 6 positive reactions). Intradermal testing with lidocaine 1%, mepivacaine 2%, and bupivacaine 0.5% was performed on 8 patients, resulting in positive reactions to lidocaine in 3 patients and to mepivacaine in 1 patient. Bupivacaine yielded negative results in each of the 8 patients. Relevance of delayed reactions to injectable lidocaine was definite in 2 cases; past, probable, and unknown in 1 case each; and possible in 11 cases. Delayed hypersensitivity to lidocaine may present as "suture allergy," treatment failure, typical contact allergy, or other local skin or dental reactions. Allergen substitution is based on further patch and intradermal testing, the results of which may be discordant.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.003 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".