BACKGROUND Lidocaine/prilocaine (EMLA) cream is a local anesthetic that is applied to the skin or mucosa during painful therapeutic procedures with few reported side effects. CASE SUMMARY Here, we report the use of dermatoscopy to identify a case of erythema with purpura, a rare side effect, after the application of 5% EMLA cream. CONCLUSION We conclude that erythema with purpura is caused by irritation and toxicity associated with EMLA, but the specific mechanism by which the toxic substance affects skin blood vessels is unclear. In response to this situation and for cosmetic needs, we recommend tranexamic acid, in addition to routine therapy, to prevent changes in pigmentation in patients with dermatitis.
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Xiu et al. (2024) studied this question.
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