Abstract
Full-thickness skin necrosis can occur after infiltration of 1.0% lidocaine with 1/100,000 epinephrine for ambulatory phlebectomy. To demonstrate an exaggerated local response to epinephrine resulting in full-thickness skin necrosis and ultimately a permanent scar. A postoperative complication was clinically observed. Permanent scar formation after ambulatory phlebectomy was found in a patient with a previous probable exaggerated local response to epinephrine. Uneventful phlebectomy resulted in the same patient when epinephrine was deleted from the local anesthetic, suggesting a local inability to eliminate epinephrine or an exaggerated local alpha-one response.
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