Severe cutaneous eruptions following the topical use of preparations containing bufexamac: Is it time to reconsider its registration in Australia?

Harris, Andrew G.; Saikal, Samra L; Scurry, Jim; Relic, John; Nixon, Rosemary; Chee, Paul

doi:10.1111/ajd.12910

Cited by 6 publications

(3 citation statements)

References 6 publications

(6 reference statements)

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“…Currently, it is not available in New Zealand, Japan, the European Union, the USA or Canada. Various Australian pharmaceutical companies do not produce bufexamac anymore, although it is still available in that country 42 . Therefore, the role of bufexamac in SAD may decrease considerably.…”

Section: Discussionmentioning

confidence: 99%

Systemic allergic dermatitis (systemic contact dermatitis) from pharmaceutical drugs: A review

Groot¹

2021

Contact Dermatitis

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The literature on systemic allergic dermatitis (SAD; also known as systemic contact dermatitis) is reviewed. Both topical drugs (from absorption through mucosae or skin) and systemic drugs (oral, parenteral, rectal) may be responsible for the disorder. The topical route appears to be rare with 41 culprit topical drugs found to cause SAD in 95 patients. Most reactions are caused by budesonide (especially from inhalation), bufexamac, and dibucaine. SAD from systemic drugs is infrequent with 95 culprit drugs found to cause SAD in 240 patients. The drugs most frequently implicated are mitomycin C, methylprednisolone (salt, ester), and hydrocortisone (salt). The largest group of culprit drugs consisted of corticosteroids (19%), being responsible for >30% of the reactions, of which nearly 40% were not caused by therapeutic drugs, but by drug provocation tests. The most frequent manifestations of SAD from drugs are eczematous eruptions (scattered, widespread, generalized, worsening, reactivation), maculopapular eruptions, symmetrical drug‐related intertriginous and flexural exanthema (SDRIFE [baboon syndrome]) and widespread erythema or erythroderma. Therapeutic systemic drugs hardly ever cause reactivation of previously positive patch tests and infrequently of previous allergic contact dermatitis. The pathophysiology of SAD has received very little attention. Explanations for the rarity of SAD are suggested.

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Section: Discussionmentioning

confidence: 99%

Systemic allergic dermatitis (systemic contact dermatitis) from pharmaceutical drugs: A review

Groot¹

2021

Contact Dermatitis

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“…Previous studies have shown that 2%–4% of emergency department (ED) presentations in Australia result from dermatological conditions, with the majority being triaged as low urgency 3,4 . The now‐banned topical anti‐inflammatory bufexamac had caused several cases of severe ACD leading to hospitalization, and this had highlighted the dearth of information of the causes of severe ACD presenting to EDs 5,6 …”

Section: Introductionmentioning

confidence: 99%

“…3,4 The now-banned topical anti-inflammatory bufexamac had caused several cases of severe ACD leading to hospitalization, and this had highlighted the dearth of information of the causes of severe ACD presenting to EDs. 5,6 The aim of this study was to identify cases of ACD presenting to EDs in a large Australian city, with emphasis on the causes of severe and acute cases of ACD, and their management. The mean age of patients was 37 years (range 0-87), and females accounted for 47.4% (108/228).…”

Section: Introductionmentioning

confidence: 99%

Presentations to emergency departments in Melbourne, Australia diagnosed as allergic contact dermatitis

et al. 2022

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Background: This study investigated cases diagnosed as allergic contact dermatitis (ACD) in emergency departments (EDs) and management. Methods: A multisite retrospective study of patients attending EDs in metropolitan Melbourne between July 2017 and June 2018 was performed. Using International Statistical Classification of Disease-10 (ICD-10) codes, the Victorian Agency for Health Information generated a list of cases of contact dermatitis (CD). Demographic and clinical data were analysed.Results: Two hundred twenty-eighty patients from 14 different sites were diagnosed with ACD. Hair dyes caused the most cases, and one such case was admitted to hospital.It was apparent from the specified causes that cases of irritant CD were misdiagnosed as ACD.There were significant differences in management with dermatology input, with dermatologists more often advising oral corticosteroids (33.3% vs. 14.5%, P = 0.004) topical corticosteroids (92.9% vs. 38.7%, P < 0.01), emollients (38.1% vs. 20.4%, P = 0.01) and less often advising antihistamines (16.7% vs. 44.6%, P < 0.001). With dermatology input, potent or very potent steroids were more likely to be prescribed (69.3% vs. 11.1%, P < 0.001); without, a mild potency steroid was more likely to be prescribed (63.9% vs. 4%, P = 0.01). Conclusion:Improved understanding, diagnosis and management of CD are needed in EDs.

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Contact Allergy to Topical Drugs

Goossens¹,

Gonçalo²

2020

Contact Dermatitis

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Severe cutaneous eruptions following the topical use of preparations containing bufexamac: Is it time to reconsider its registration in Australia?

Cited by 6 publications

References 6 publications

Systemic allergic dermatitis (systemic contact dermatitis) from pharmaceutical drugs: A review

Systemic allergic dermatitis (systemic contact dermatitis) from pharmaceutical drugs: A review

Presentations to emergency departments in Melbourne, Australia diagnosed as allergic contact dermatitis

Contact Allergy to Topical Drugs

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