Author: Samra L Saikal. Unaccredited Registrar, Lotus Dermatology, Newcastle, NSW, Australia. DermNet NZ Editor in Chief: Adjunct A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand. Copy edited by Gus Mitchell. August 2018.
Bufexamac is a well-recognised cause of allergic contact dermatitis at the site of application, and it may also cause a widespread polymorphic cutaneous eruption.
Bufexamac preparations have been traditionally used to treat insect bites, stings, minor cuts, abrasions, sunburn, thermal burns and inflammatory dermatoses (such as dermatitis) [1,2]. However, there is scarce evidence substantiating its efficacy . It has also been previously manufactured as a suppository for haemorrhoids.
Due to its adverse effects and establishment as a contact allergen, bufexamac is not available in the following countries as of August 2018 [1,4]:
Bufexamac is still available over the counter in other countries. In Australia, it is available as a 5% topical preparation in combination with 1% lidocaine hydrochloride monohydrate and 0.1% chlorhexidine gluconate (2018).
Bufexamac has been established as a cause of allergic contact dermatitis . It can also result in [1,5-11]:
An adverse reaction to bufexamac is diagnosed by taking a careful history, examining the rash, and patch testing.
An allergic reaction to bufexamac may appear similar to the condition for which bufexamac was being used, so reactions to bufexamac may be underreported.
Use of bufexamac should be stopped and it should be avoided long term.
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