Farsi Mishma A, Markal Asena, Maddy Austin, Forouzandeh Mahtab, Motaparthi Kiran
College of Medicine, Medical College of Georgia, Augusta University, Augusta, USA.
Department of Family Medicine, University of Florida College of Medicine, Gainesville, USA.
Cureus. 2024 Nov 7;16(11):e73248. doi: 10.7759/cureus.73248. eCollection 2024 Nov.
Symmetric drug-related intertriginous and flexural exanthem (SDRIFE) is a rare delayed-type hypersensitivity reaction that is considered a variant of systemic allergic contact dermatitis. It is typically triggered by drugs such as beta-lactam antibiotics or antihypertensives. The reaction presents as erythema with flexural prominence. However, we report a particularly rare blistering variant following administration of trimethoprim/sulfamethoxazole (TMP/SMX). Although the histopathological findings were nonspecific, the distribution and lack of systemic and mucosal involvement allowed distinction from other blistering cutaneous adverse reactions with flexural prominence. This case highlights the importance of differentiating SDRIFE from other drug eruptions with flexural distribution and includes a comprehensive differential diagnosis.
对称性药物相关性屈侧和间擦疹（SDRIFE）是一种罕见的迟发型超敏反应，被认为是系统性过敏性接触性皮炎的一种变体。它通常由β-内酰胺类抗生素或抗高血压药等药物引发。该反应表现为屈侧突出部位的红斑。然而，我们报告了1例服用甲氧苄啶/磺胺甲恶唑（TMP/SMX）后出现的极为罕见的水疱型变体。尽管组织病理学结果不具有特异性，但皮疹分布以及无全身和黏膜受累情况有助于将其与其他屈侧突出部位的水疱性皮肤不良反应相鉴别。本病例强调了将SDRIFE与其他屈侧分布的药疹相鉴别的重要性，并给出了全面的鉴别诊断。
