Systemic Drug Related Intertriginous and Flexural Exanthema (SDRIFE) or Intertriginous Drug Eruption: a matter of semantics

Abstract

Systemic drug-related intertriginous and flexural exanthema (SDRIFE) is a recently coined term to describe an uncommon adverse cutaneous drug reaction described previously as intertriginous drug eruption or flexural drug exanthema. Characteristic flexural erythema notably of the axillae and groins following systemic administration of offending drug may eventuate to TEN-like eruption with relative absence of systemic involvement. Beta-lactam antibiotics like amoxicillin remain the most common offending drug. A1-year-old boy developed SDRIEF overnight after oral amoxicillin(125mg) given for upper respiratory infection. The eruptions deteriorated evolving to TEN-like skin tenderness and exfoliation despite withdrawal of offending drug and treatment with oral cetirizine and prednisolone. It subsided within 1-2days after intravenous immunoglobulin treatment. The putative drugs and various pathogenetic mechanisms proposed for this very unusual adverse cutaneous drug reaction reflects that the nomenclature SDRIFE, intertriginous drug eruption or flexural drug exanthema is just semantics

Keywords

• amoxicillin
• baboon syndrome
• flexural drug eruption
• intertriginous drug eruption
• sdrife