The eutectic mixture EMLA cream has many medical uses, including pain relief for hemodialyzed patients prior to cannulation. Cutaneous side effects associated with its application have rarely been reported. A patient on hemodialysis developed an itchy eruption over his brachial arteriovenous fistula, where he was applying EMLA cream three times per week, prior to puncture for hemodialysis. Patch testing elicited a positive reaction to several allergens, including EMLA cream “as is” and prilocaine. The lesions resolved after topical treatment with corticosteroids.
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WatonJ, BoulangerA, TrechotPH, et al.Contact urticaria from EMLA cream. Contact Dermatitis, 2004; 51:284-7.
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CalobrisiSD, DroletBA, EsterlyNB. Petechial eruption after the application of EMLA cream. Pediatrics, 1998; 101:471-3.
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De WaardFB, OranjeAP. Purpura caused by EMLA is of toxic origin. Contact Dermatitis, 1997; 36:11-3.
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IsmailF, GoldsmithPC. EMLA cream-induced allergic contact dermatitis in a child with thalassaemia major. Contact Dermatitis, 2005; 52:111.
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Le CozCJ, CribierBJ, HeidE. Patch testing in suspected allergic contact dermatitis due to EMLA cream in haemodialized patients. Contact Dermatitis, 1996; 35:316-7.
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ThakurBK, MuraliMR. EMLA cream-induced allergic contact dermatitis: a role for prilocaine as an immunogen. J Allergy Clin Immunol, 1995; 95:776-8.
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Van den HoveJ, DecroixJ, TennstedtD, LachapelleJM. Allergic contact dermatitis from prilocaine, one of the local anesthetics in EMLA cream. Contact Dermatitis, 1994; 30:239.
