Letter: Paraben-induced dermatitis.

Abstract

To the Editor.— In their Letter to the Editor concerning systemic eczematous contact-type dermatitis medicamentosa caused by parabens, Aeling and Nuss 1 report a paraben-sensitive individual whose dermatitis apparently was exacerbated following the injection of lidocaine (Xylocaine), which contains a paraben as a preservative. The authors state: Although not definitely proven, we think his exacerbation was probably secondary to the methylparaben preservative, 0.001 gm/ml, in the lidocaine used for mandibular block anesthesia. They also state: Aldrete and Johnson 2 reported the case of a patient who was initially thought to have an immediate (type 1) hypersensitivity to lidocaine. However, direct skin testing and Prausnitz-Kustner reaction revealed negative tests to the lidocaine and positive tests to methylparaben, thus proving that parabens in multidose vials of lidocaine can cause immediate hypersensitivity. It must be strongly emphasized that the immediate hypersensitivity reported by Aldrete and Johnson is not mediated by, or related