A Case of Wasp-induced Pain Treated with Topical Phenytoin Cream

Abstract

Phenytoin cream has been evaluated in many patients suffering from peripheral neuropathic pain. Its onset of action has been documented to be within 30 minutes. Its mechanism of action is via the inhibition of sodium channels of the nociceptors in the skin, as well as the inhibition of a number of secondary targets in the skin, such as the keratinocytes and possibly immune-competent cells. Here we describe for the first time the successful treatment of lingering neuralgiformic pains after a wasp sting. Within 20 minutes after application of 10% phenytoin cream, the pain vanished completely. Phenytoin cream might therefore also be of use in the treatment of pain induced by stinging insects.