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

Despite being a well-recognised cause of allergic contact dermatitis with an embargo in many countries around the world, bufexamac is available over the counter in topical preparations in Australia. We present a series of patients who developed severe cutaneous eruptions after the topical application of bufexamac containing preparations to highlight the potential risks of this medication, as well as advocate for the reconsideration of its registration by the Therapeutic Goods Administration in Australia.

The first Australian Baseline Series: Recommendations for patch testing in suspected contact dermatitis.

BACKGROUND AND OBJECTIVES: Patch testing is a standard diagnostic tool used in the identification of causative allergens in allergic contact dermatitis. Ongoing surveillance of rates of allergen positivity is vitally important to detect trends and allow comparisons between countries. The objective of this study was to propose the first evidence-based Australian baseline series, based on retrospective review of our patch test data. We aimed to identify the most important and most relevant allergens in our population. METHODS: We conducted a 10-year (2001-2010) retrospective review of data from the contact dermatitis clinic and the occupational dermatitis clinic from our institution. RESULTS: We patch tested 5281 patients in all. The top 20 allergens with the highest number of relevant positive patch test reactions were: fragrance mix 1: nickel, potassium dichromate, Myroxylon pereirae, formaldehyde, p-phenylenediamine (PPD), thiuram mix, colophony (rosin), dermatophagoides mix, ammonium persulfate, quaternium-15, cobalt chloride, methylchloroisothiazolinone or methylisothiazolinone, diazolidinylurea, epoxy resin, 1,3-dimethylol-5,5-dimethyl hydantoin, Compositae mix, toluenesulfonamide formaldehyde resin, basic red 46 and imidazolidinyl urea. CONCLUSION: We have elucidated the most frequent and relevant contact allergens in our patient population and used this information to construct the first Australian baseline series.

ANTIINFLAMMATORY ACTIVITY OF BUFEXAMAC ON TOPICAL SKIN INFLAMMATION MODEL INDUCED BY FORMALDEHYDE / 中国药理学通报

The paper reported the topical skin antiinflammatory activity of bufexamac on inflammation model induced by formaldehyde in mice. Comparing with the blank cream, the effect of 0.5% bufexamac cre-am on inflammation had no statistically difference, but all those of 1% bufexamac cream at 1 and 2 h after treatment, of 2 % and 5 % bufexamac cream at 1, 2 and 4h after treatment, showed significantly difference. The antiinflammatory activity was enhanced with the increase of bufexamac concentration in cream. The antiinflammatory activity of 2 % bufexamac cream was close to the effects of 1 % indomethacin cream and 0.05 % clobetasol Cream.Furthermore, our study showed that steroid antiinflammatory agents and nonsteroid antiinflammatory agents were all active against erythema and edema produced by formaldehyde in mice. Formaldehyde and mice are cheap and easy to obtain in our country. It is of some value to use the animal model for screening the topical skin antiinflammatory agents.