Bullous allergic contact dermatitis to lidocaine

A 54-year-old woman developed a severe perianal eczematous reaction a few days after applying a lidocaine cream for haemorrhoids. She had used this cream approximately once a year, without any problem. The general practitioner prescribed TriAnal® (WillPharma BV, Zwanenburg, The Netherlands) to treat the perianal dermatitis. This worsened the dermatitis with bullae, swelling, erosions, and extending it to the genital region. An internal cause was suspected and the patient was referred to a proctologist after the dermatitis resolved. She was examined twice, using Urogliss® (Montavit