Unbound MEDLINE

Symmetrical drug-related intertriginous and flexural exanthema.

Abstract

PURPOSE OF REVIEW
Symmetrical drug-related intertriginous and flexural exanthema (SDRIFE), previously termed drug-related baboon syndrome, is a benign and self-limiting type IV hypersensitivity reaction characterized by symmetrical erythema involving the gluteal and intertriginous areas in the absence of systemic involvement. It may also occur in the absence of previous drug exposure.
RECENT FINDINGS
Antibiotics, in particular beta-lactams, comprise the majority of causes of SDRIFE. Other drugs which have been implicated include antihypertensives, radiocontrast media, chemotherapeutic agents, and biologics. Histology of lesional skin is variable with predominance of superficial perivascular inflammatory cell infiltrates. Outcomes of allergy tests are variable with positive delayed intradermal tests reported for penicillin V, allopurinol; positive patch tests for erythromycin, mitomycin, nystatin, pseudoephdrine; positive lymphocyte transformation tests for erythromycin; and positive drug provocation tests for clindamycin, cimetidine, corticosteroids, terbinafine, and valacyclovir.
SUMMARY
Diagnosis of SDRIFE is dependent upon recognition of the clinical morphology and distribution of the rash, and its temporal relationship to the use of the suspected drug. Outcomes of in-vivo and in-vitro tests have been inconsistent, and thus may not be useful in the identification of the putative drug.

Links

  • Publisher Full Text
  • Authors

    Tan SC, Tan JW

    Institution

    Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore, Singapore. Sze_Chin_Tan@ttsh.com.sg

    Source

    Current opinion in allergy and clinical immunology 11:4 2011 Aug pg 313-8

    MeSH

    Age Distribution
    Dermatitis, Allergic Contact
    Diagnosis, Differential
    Exanthema
    Humans
    Lymphocyte Activation
    Organ Specificity
    Pharmaceutical Preparations
    Sex Distribution
    Skin
    Skin Diseases, Vesiculobullous
    Skin Tests
    Syndrome
    T-Lymphocyte Subsets

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    21659857