Symmetrical drug-related intertriginous and flexural exanthema (SDRIFE) after administration of corticosteroids: Case series and review of literature.

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  • Additional Information
    • Source:
      Publisher: Wiley Country of Publication: England NLM ID: 7604950 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1600-0536 (Electronic) Linking ISSN: 01051873 NLM ISO Abbreviation: Contact Dermatitis Subsets: MEDLINE
    • Publication Information:
      Publication: <2005-> : Oxford : Wiley
      Original Publication: Copenhagen, Munksgaard.
    • Subject Terms:
      Drug Eruptions*/etiology ; Drug Eruptions*/diagnosis ; Exanthema*/chemically induced ; Prednisolone*/therapeutic use ; Prednisolone*/administration & dosage; Humans ; Female ; Middle Aged ; Male ; Adult ; Cross Reactions ; Aged ; Patch Tests ; Glucocorticoids/therapeutic use ; Glucocorticoids/administration & dosage
    • Abstract:
      Background: Cutaneous manifestations of drug-induced type IV reactions vary widely, with symmetrical drug-related intertriginous and flexural exanthema (SDRIFE) being a less common presentation. Corticosteroids (CS), primarily known for their anti-inflammatory effects, rarely induce hypersensitivity reactions.
      Objective: The aim of this case series is to report four cases of SDRIFE following systemic prednisolone therapy and to review existing CS classification proposals to better understand cross-reactivity of CS.
      Patients/methods: Patients recruited at a German dermatology centre underwent allergologic evaluation including prick and patch testing with various CS. Positive cases underwent oral challenge testing with alternative agents. The classification systems of Coopman et al. and Baeck et al. were taken into account.
      Discussion: Despite a paucity of literature, CS-induced type IV reactions do occur, including SDRIFE. Classification systems based on chemical structure provide insight into cross-reactivity patterns. Provocation tests with alternative CS highlight the complexity of managing CS hypersensitivity.
      Conclusion: SDRIFE may develop following systemic prednisolone therapy. Classification systems are helpful in understanding cross-reactivity and help in the selection of alternative preparations but are not always reliable. Individualised assessment is crucial for managing CS hypersensitivity, with consideration of alternative agents and emergency use of CS when necessary.
      (© 2024 The Author(s). Contact Dermatitis published by John Wiley & Sons Ltd.)
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    • Contributed Indexing:
      Keywords: SDRIFE; contact allergy; corticosteroids; symmetrical drug‐related intertriginous and flexural exanthema
    • Accession Number:
      9PHQ9Y1OLM (Prednisolone)
      0 (Glucocorticoids)
    • Publication Date:
      Date Created: 20240521 Date Completed: 20240711 Latest Revision: 20240911
    • Publication Date:
      20240912
    • Accession Number:
      10.1111/cod.14594
    • Accession Number:
      38769741