Type I hypersensitivity reactions to lidocaine are infrequent, whilst type IV- delayed hypersensitivity reactions are even rarer, with only a few reported cases in the literature. A proper diagnosis is essential to differentiate between the two for appropriate management. As local anaesthetic agents are routinely used for various invasive procedures, it is imperative to be familiar with the presentation and management of such allergic reactions.
We present a case of a morbidly obese obstetric patient who developed allergic contact dermatitis (ACD) after receiving subcutaneous lidocaine before subarachnoid block. The patch test was positive for lidocaine, and a positive intradermal challenge test confirmed the diagnosis.
Key words: lidocaine, allergic contact dermatitis, case report, lidocaine hypersensitivity, patch test
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