1
|
Schuler AM, Smith EH, Chaudet KM, Bresler SC, Gudjonsson JE, Kroshinsky D, Nazarian RM, Chan MP. Symmetric drug-related intertriginous and flexural exanthema: Clinicopathologic study of 19 cases and review of literature. J Cutan Pathol 2021; 48:1471-1479. [PMID: 34159622 DOI: 10.1111/cup.14090] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 06/08/2021] [Accepted: 06/18/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND Symmetric drug-related intertriginous and flexural exanthema (SDRIFE) is a cutaneous drug reaction characterized by gluteal/anogenital erythema and symmetric involvement of other intertriginous location(s) without systemic signs. Clinicopathologic characterization has been limited to case reports and small series. We describe 19 new cases and review the literature to better define the clinical and histopathologic spectrum of SDRIFE. METHODS Pathology archives were searched for "SDRIFE" and "baboon syndrome." Cases meeting clinical criteria were included. Clinical and histopathologic features were recorded. Previous reports of SDRIFE with histopathologic descriptions were reviewed. RESULTS Nineteen new cases were included, over half triggered by antibiotics. Six new causative medications were identified. Median onset was 7 days. Typical lesions were erythematous plaques or papules with or without scale. The most common histopathologic finding was superficial perivascular lymphocytic infiltrate followed by dermal eosinophils, spongiosis, and orthokeratosis. Basal vacuolization and apoptotic keratinocytes were less common. Interstitial histiocytes were present in almost half of our cases. Other findings included atypical lymphocytes and "flame figure." CONCLUSIONS Appreciation of the range of inciting medications and clinicopathologic features in SDRIFE will improve recognition of this condition. Although many histopathologic features overlap with other common dermatitides, biopsy may assist in excluding key clinical mimics.
Collapse
Affiliation(s)
- Andrew M Schuler
- Department of Dermatology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Emily H Smith
- Department of Dermatology, University of Missouri, Columbia, Missouri, USA
| | - Kristine M Chaudet
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Scott C Bresler
- Department of Dermatology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA.,Department of Pathology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Johann E Gudjonsson
- Department of Dermatology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Daniela Kroshinsky
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Rosalynn M Nazarian
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - May P Chan
- Department of Dermatology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA.,Department of Pathology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| |
Collapse
|
2
|
Heck J, Stichtenoth DO, Mettin R, Jöckel J, Bickel C, Krichevsky B. Remdesivir-induced symmetrical drug-related intertriginous and flexural exanthema (SDRIFE)? A case report with review of the literature. Eur J Clin Pharmacol 2021; 77:141-144. [PMID: 32761371 PMCID: PMC7406697 DOI: 10.1007/s00228-020-02955-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 07/03/2020] [Indexed: 11/25/2022]
Affiliation(s)
- Johannes Heck
- Institute for Clinical Pharmacology, Hannover Medical School, Hannover, Germany
| | - Dirk O Stichtenoth
- Institute for Clinical Pharmacology, Hannover Medical School, Hannover, Germany
| | - Roland Mettin
- Central Hospital of the German Armed Forces (Bundeswehrzentralkrankenhaus), Rübenacher Straße 170, 56072, Koblenz, Germany
| | - Jörg Jöckel
- Central Hospital of the German Armed Forces (Bundeswehrzentralkrankenhaus), Rübenacher Straße 170, 56072, Koblenz, Germany
| | - Christoph Bickel
- Central Hospital of the German Armed Forces (Bundeswehrzentralkrankenhaus), Rübenacher Straße 170, 56072, Koblenz, Germany
| | - Benjamin Krichevsky
- Central Hospital of the German Armed Forces (Bundeswehrzentralkrankenhaus), Rübenacher Straße 170, 56072, Koblenz, Germany.
| |
Collapse
|
3
|
de Risi-Pugliese T, Barailler H, Hamelin A, Amsler E, Gaouar H, Kurihara F, Jullie ML, Merrill ED, Barbaud A, Moguelet P, Milpied-Homsi B, Soria A. Symmetrical drug-related intertriginous and flexural exanthema: A little-known drug allergy. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2020; 8:3185-3189.e4. [PMID: 32376489 DOI: 10.1016/j.jaip.2020.04.052] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 04/08/2020] [Accepted: 04/21/2020] [Indexed: 12/20/2022]
Affiliation(s)
- Tullia de Risi-Pugliese
- AP-HP, Service de Dermatologie et Allergologie, Hôpital Tenon, Paris, France; Sorbonne Université, UPMC University, Paris, France.
| | | | - Aurore Hamelin
- AP-HP, Service de Dermatologie et Allergologie, Hôpital Tenon, Paris, France
| | - Emmanuelle Amsler
- AP-HP, Service de Dermatologie et Allergologie, Hôpital Tenon, Paris, France; Sorbonne Université, UPMC University, Paris, France
| | - Hafida Gaouar
- AP-HP, Service de Dermatologie et Allergologie, Hôpital Tenon, Paris, France
| | - Flore Kurihara
- AP-HP, Service de Dermatologie et Allergologie, Hôpital Tenon, Paris, France; Sorbonne Université, UPMC University, Paris, France
| | | | - Eric Dean Merrill
- Department of Dermatology, University of California San Francisco, San Francisco, Calif
| | - Annick Barbaud
- AP-HP, Service de Dermatologie et Allergologie, Hôpital Tenon, Paris, France; Sorbonne Université, UPMC University, Paris, France
| | | | | | - Angèle Soria
- AP-HP, Service de Dermatologie et Allergologie, Hôpital Tenon, Paris, France; Sorbonne Université, UPMC University, Paris, France; Inserm 1135, Centre d'Immunologie et des Maladies Infectieuses (Cimi-Paris), Paris, France
| |
Collapse
|
4
|
Nespoulous L, Matei I, Charissoux A, Bédane C, Assikar S. Symmetrical drug-related intertriginous and flexural exanthema (SDRIFE) associated with pristinamycin, secnidazole, and nefopam, with a review of the literature. Contact Dermatitis 2018; 79:378-380. [DOI: 10.1111/cod.13084] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 06/21/2018] [Accepted: 06/23/2018] [Indexed: 12/23/2022]
Affiliation(s)
| | - Ioana Matei
- Department of Dermatology; University Hospital Centre; Limoges France
| | | | - Christophe Bédane
- Department of Dermatology; University Hospital Centre; Limoges France
| | - Safaë Assikar
- Department of Dermatology; University Hospital Centre; Limoges France
| |
Collapse
|