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