Symmetrical drug related intertriginous and flexural exanthema (SDRIFE) induced by fluconazole: An uncommon side effect of a commonly used drug

Docetaxel‐induced symmetrical drug‐related intertriginous and flexural exanthema (SDRIFE) confirmed by skin testing

“…However, it may progress to a generalised maculopapular exanthema if the eliciting drug is not withdrawn as in our case. 9 Based on positive patches, positive delayed intradermal, and lymphocyte transformation tests, the most common underlying mechanism is a T-cell mediated hematogenic contact dermatitis. 10 Immunohistochemical evaluation revealed increased expression of CD26P-selectin on endothelial cells and keratinocytes, with…”

Remdesivir-induced symmetrical drug–related intertriginous and flexural exanthema (SDRIFE)? A case report with review of the literature

“…SDRIFE is clinically defined by five criteria: (i) onset after initial or repeated exposure to a systemically administered drug (contact allergens excluded), (ii) sharply demarcated erythema in the gluteal/perianal area and/or V-shaped erythema in the inguinal/perigenital region, (iii) involvement of at least one other intertriginous/flexural fold (e.g., axillae, antecubital fossae), (iv) symmetrical distribution, and (v) absence of systemic involvement [4]. Beta-lactam antibiotics, especially amoxicillin, are recognized as the most frequent trigger of SDRIFE [4,5]. The clinical course of SDRIFE usually is benign and self-limited.…”

“…Treatment of SDRIFE consists of discontinuation of the offending agent. Additionally, antihistamines and topical/ systemic glucocorticosteroids may provide symptomatic relief and speed up the healing process [5,7,8].…”

“…Depending on the clinical context, the differential diagnosis of SDRIFE includes other cADRs such as acute generalized exanthematous pustulosis, drug reaction with eosinophilia and systemic symptoms, and (multifocal) fixed drug eruption, as well as nondrug-related dermatologic conditions, e.g., tinea cruris and inverse psoriasis [5,7,11]. A plethora of cutaneous manifestations have been described in connection with COVID-19 [47], including an SDRIFE-like exanthema [48].…”

“…PubMed was searched for case reports/series of SDRIFE in order to update preexisting lists of SDRIFE-eliciting drugs [ 3 – 5 , 10 , 11 ]. All identified publications were reviewed, and SDRIFE-eliciting drugs were extracted.…”