Ann Dermatol.  2018 Oct;30(5):606-609. 10.5021/ad.2018.30.5.606.

Symmetrical Drug-Related Intertriginous and Flexural Exanthema: Two Cases and Brief Literature Review

Affiliations
  • 1Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea. drseo@hanafos.com

Abstract

It has been reported that there are a range of causative drugs related to symmetrical drug-related intertriginous and flexural exanthema (SDRIFE). The causative drugs reported so far include the following: antibiotics, intravenous immunoglobulin, chemotherapeutic agents, and biologics. In this study, we report two cases of SDRIFE and a review of the previous literature. We believe that our study makes a significant contribution to the literature because it demonstrates that intradermal injection of the Chinese herbal ball, and not its topical application, elicited a reaction that predicted the occurrence of SDRIFE. This finding is important for the diagnosis of SDRIFE in future studies. Our findings also provide evidence for a SDRIFE reaction after exposure to ranitidine and mosapride.

Keyword

Chinese herbal ball; Mosapride; Ranitidine; Symmetrical drug-related intertriginous and flexural exanthema; Urushiol

MeSH Terms

Anti-Bacterial Agents
Asian Continental Ancestry Group
Biological Products
Diagnosis
Exanthema*
Humans
Immunoglobulins
Injections, Intradermal
Ranitidine
Anti-Bacterial Agents
Biological Products
Immunoglobulins
Ranitidine

Figure

  • Fig. 1 (A~E) Symmetrical erythematous scaly patches on the antecubital fossa, flank, and inguinal area. Delayed intradermal test (F) immediately after injection. (G) Forty-eight hours later, there was a strong positive finding at the injection site of the 1:10 ratio solution. We received the patient's consent form about publishing all photographic materials.

  • Fig. 2 (A~E) Symmetrical erythematous, scaly patches involving the forehead, perioral area, neck, inguinal area, and flexural area. (F) Dermal edema with mixed inflammatory cell infiltration (H&E, ×100). (G) There were many eosinophils in the dermis (H&E, ×400). We received the patient's consent form about publishing all photographic materials.


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