Contact dermatitis bufexamac

Bufexamac is intended for topical use as a cream (using iontophoresis, ultrasound, and massage). Local intolerance causes burning and irritation, attributable to components of the cream. Urticaria, folliculitis, and pyoderma can occur when occlusive dressings are used. The course of contact allergy by bufexamac was particularly protracted and refractory in most of the 24 patients observed in one hospital in 1983-1987 (1). An erythema multi-forme-like rash associated with contact dermatitis has been reported (SEDA-18, 103). In children, long-term topical use of bufexamac was well tolerated with few mild local adverse effects (SEDA-20, 91). 

A case of photoallergic contact dermatitis from aceclo-fenac has been reported (189). Photopatch tests were positive with aceclofenac 10% in petrolatum, but not with either aceclofenac 1% or 5% in petrolatum or with a series of NSAIDs and other analgesics (benzydamine hydrochloride 3 and 5%, bufexamac 5%, diclofenac 1, 5, and 10%, fepradinol 1%, ibuprofen 5%, indometacin 1, 5, and 10%, ketoprofen 1%, naproxen 5%, paracetamol 1, 5, and 10%, phenylbutazone 1%, piroxicam 1%, salicylic acid 1 and 5%, and thiosalicylic acid 0.1%, all in petrolatum). 

Kranke B, Szolar-Platzer C, Komericki P, Derhaschnig J, Aberer W. Epidemiological significance of bufexamac as a frequent and relevant contact sensitizer. Contact Dermatitis 1997 36(4) 212-15. 

Krook G (1975) Contact sensitivity to oxyphenbutazone (tanderil) and cross sensitivity to phenylbutazone (butazolidine). Contact Dermatitis 1 385-386 Lachapelle JM (1975) Contact sensitivity to bufexamac. Contact Dermatitis 1 261... 

Knight TE, Hausen BM (1994) Melaleuca oil (tea tree oil) dermatitis. J Am Acad Dermatol 30 423-427 Kranke B, Derhaschnig J, Komericki P, Aberer W (1996) Bufexamac is a frequent contact sensitizer. Contact Dermatitis 34 63-64... 

Contact and photo-contact dermatitis Diclofenac, indomethacin, ibuprofen, flurbiprofen, ketoprofen, flufenamic acid, etofenamate, bufexamac, tiaprofenic acid Topical ketoprofen frequently implicated Chemically related cross-reactivity observed Patients sensitized topically may develop cutaneous reactions to same drug given orally or parenterally... 

Belhadjali H, Ghannouchi N, Njim L, Mohamed M, Moussa A, Bayou F, Chakroun M, Zakhama A, Zili J. Acute generalized exanthematous pustulosis induced by bufexamac in an atopic girl. Contact Dermatitis 2008 58(4) 247-8. 

Contact dermatitis may occur following the topical application of creams containing bufexamac (145 ). 

---