Sahu Kananbala, Sirka Chandra S, Pradhan Swetalina, Rout Arpita N
Department of Dermatology, Venereology and Leprology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
Indian Dermatol Online J. 2020 Jan 13;11(1):62-64. doi: 10.4103/idoj.IDOJ_104_19. eCollection 2020 Jan-Feb.
Symmetrical drug-related intertriginous and flexural exanthema (SDRIFE), and fixed drug eruption (FDE) are adverse cutaneous drug reactions. SDRIFE is most commonly associated with the use of beta-lactam antibiotics. There is only one case report describing SDRIFE due to intake of doxycycline in literature. Previously reported case describes the characteristic morphology of well-defined macular erythema over the flexural and intertriginous area. We here in report a 38-year-old male presented with unusual morphology of SDRIFE, and well circumscribed erythematous patches suggestive of FDE on the thigh and back after doxycycline intake. Histopathology was consistent with SDRIFE and FDE respectively. The skin lesions improved with 5 days of 40 mg oral prednisolone. After 6 weeks, drug provocation with doxycycline was done following which patient developed itching and erythema over the older sites. Though there is a single published report of SDRIFE due to doxycycline, our case had additional findings of having pigmented FDE lesions along with flexural lesions of SDRIFE.
对称性药物相关性褶烂和屈侧疹（SDRIFE）以及固定性药疹（FDE）是药物引起的皮肤不良反应。SDRIFE最常与β-内酰胺类抗生素的使用有关。文献中仅有一篇病例报告描述了因服用多西环素导致的SDRIFE。先前报道的病例描述了屈侧和褶烂部位边界清晰的斑疹性红斑的特征形态。我们在此报告一名38岁男性，在服用多西环素后出现了不寻常形态的SDRIFE，以及大腿和背部边界清晰的红斑，提示为FDE。组织病理学分别与SDRIFE和FDE相符。口服40mg泼尼松龙5天后皮肤病变有所改善。6周后，对患者进行多西环素激发试验，之后患者原发病灶处出现瘙痒和红斑。尽管有一篇已发表的关于多西环素导致SDRIFE的报告，但我们的病例有额外的发现，即除了SDRIFE的屈侧病变外，还出现了色素沉着的FDE病变。
