Severe allergic contact dermatitis caused by topical bufexamac requiring hospitalization

Wong, Gwyneth Natalie; Shen, Sarah; Nixon, Rosemary

doi:10.1111/cod.13207

Cited by 6 publications

(9 citation statements)

References 3 publications

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“…There is, however, no justification for the continued use of this topical medicament. 24 Testosterone propionate was also found as a sensitizer but is used in the treatment of lichen sclerosus of the vulvar region. 25 It is sometimes also administered via transdermal patches in men suffering from hypogonadism; however, contact allergy to it remains infrequent.…”

Section: Discussionmentioning

confidence: 99%

Iatrogenic allergic contact dermatitis in the (peri)anal and genital area

et al. 2021

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Background: Allergic contact dermatitis (ACD) from topical medication often occurs in occluded areas, for example, with wound treatment, but also in certain body locations, such as the anogenital area.Objectives: To investigate the demographics and specific lesion location of patients with ACD from topical drugs applied onto the (peri)anal/genital area, and to identify the respective causal topical pharmaceutical products and ingredients involved.Methods: From January 2000 to December 10, 2018, 532 patients were tested with the baseline series, sometimes with additional series, and the topical medication used along with the ingredients. The relevant data were extracted from our electronic databases developed in-house.Results: Forty-four patients (9%) out of 473 patients suffering from lesions in the (peri)anal/genital area had positive patch test results to topical drug preparations and/or their ingredients, sometimes in association with cosmetics for intimate hygiene. The most frequent sensitizing active principles were local anaesthetics and corticosteroids, while wool alcohols and to a minor extent benzoic acid were the most frequent culprits among the vehicle components and preservative agents, respectively. Conclusions:The local conditions (eg, occlusion, sweating, moist) in the anogenital area may favour skin sensitization to topical medication used to treat various skin diseases.

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Section: Discussionmentioning

confidence: 99%

Iatrogenic allergic contact dermatitis in the (peri)anal and genital area

et al. 2021

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“…There have been several reports of severe cases of ACD presenting to ED and requiring hospitalization. These causes include topical PPD from both hair dye and a temporary tattoo, topical bufexamac and ketoprofen 5,15–17,24,25 . In a Danish study of children with ACD to PPD, it was reported that 1 child had been admitted to intensive care and 5 to hospital 25 .…”

Section: Discussionmentioning

confidence: 99%

“…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%

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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“…In anderen Ländern, z. B. Australien, ist Bufexamac hingegen immer noch auf dem Markt und verursacht dieselben Probleme, wie im Fall eines 41-jährigen Australiers, dessen ACD so schwer war, dass er stationär behandelt werden musste [338] – die Autoren schlagen vor, die Zulassung auch außerhalb der EU zu überdenken. Während manche Allergene wie Bufexamac zwar eine schwere ACD hervorrufen können, aber leicht vermeidbar sind, sieht dies bei ubiquitär vorkommenden Allergenen wie Metallen, Konservierungsstoffen (Bioziden) oder Duftstoffen anders aus.…”

Section: Diskussionunclassified

Kontaktallergien – Neu aufkommende Allergene und Auswirkungen für das Gesundheitswesen

Uter¹,

Werfel

Lepoittevin

et al. 2021

Kompass Dermatol

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Kontaktallergie (Sensibilisierung) und daraus resultierende allergische Kontaktdermatitis (ACD) sind von erheblicher Tragweite aus Sicht des Gesundheitswesens. Für die vorliegende Übersichtsarbeit hierzu wurden alle passenden Artikel aus dem Zeitraum 2018–2019 per systematischer Suche in Medline und Web of Science<sup>TM</sup> ermittelt; außerdem wurden alle verfügbaren Ausgaben der Fachzeitschriften „Contact Dermatitis“ und „Dermatitis“ manuell durchsucht und so eine frühere, ähnliche Übersichtsarbeit fortgeschrieben und neu fokussiert. Neue Allergene ebenso wie bekannte Allergene, die in neuem Expositionskontext gefunden wurden oder deren Bedeutung in sonstiger Hinsicht neu bewertet wurde, werden in Abschnitten nach Substanzklasse gegliedert beschrieben (z. B. Metalle, Konservierungsmittel, Duftstoffe). Als gemeinsames Ergebnis zahlreicher Untersuchungen fällt sowohl ein Mangel an Informationen über die Produktzusammensetzung auf, z. B. in Bezug auf ein neu beschriebenes Allergen in Leinenturnschuhen (Dimethylthiocarbamylbenzothiazolsulfid), als auch vor allem die mangelnde Kooperativität von Herstellern von Blutzuckermessgeräten bzw. Insulinpumpen. Zu den letztgenannten Geräten hat eine internationale Zusammenarbeit zwischen Dermatologen und Chemikern gezeigt, dass sie bei zahlreichen Diabetikern schwere ACD verursachen, indem sie Isobornylacrylat bzw. N,N’-Dimethylacrylamid freisetzen. Eine verbesserte und vollständige Deklaration der Inhaltsstoffe für Produkte alle Art – und nicht nur, wie wir es derzeit in Europa haben, bei Kosmetika (abgesehen von der vollständigen Auflistung der Duftstoffe) – muss auf die legislative Agenda gesetzt werden.

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Severe allergic contact dermatitis caused by topical bufexamac requiring hospitalization

Cited by 6 publications

References 3 publications

Iatrogenic allergic contact dermatitis in the (peri)anal and genital area

Iatrogenic allergic contact dermatitis in the (peri)anal and genital area

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

Kontaktallergien – Neu aufkommende Allergene und Auswirkungen für das Gesundheitswesen

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