SDRIFE — SCE Dermatology MCQ

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ModerateDrug ReactionsSDRIFESCE Dermatology

A 50-year-old woman presents with a diffuse symmetric erythematous rash on her buttocks and inner thighs sparing the creases. She started a new systemic antibiotic (Amoxicillin) 2 days ago. The rash is well-demarcated and symmetrical. What is this pattern called?

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Correct answer: E — Symmetrical drug-related intertriginous and flexural exanthema (SDRIFE/baboon syndrome)

SDRIFE (Symmetrical Drug-Related Intertriginous and Flexural Exanthema), previously known as baboon syndrome, presents with well-demarcated symmetrical erythema of the gluteal/inguinal areas and flexural sites, typically within days of systemic drug exposure. Criteria include: symmetrical erythema of gluteal/inguinal area, involvement of ≥1 other flexural fold, and absence of systemic symptoms. Beta-lactam antibiotics (Amoxicillin) are the most common trigger. It is a type IV (delayed) hypersensitivity reaction. Management is drug withdrawal and topical corticosteroids. It should be distinguished from fixed drug eruption (asymmetric, well-defined, violaceous) and DRESS (systemic involvement).

Reference: BAD 2019 Drug Eruption Guidelines; JACI SDRIFE criteria