HistoryThis section has been translated automatically.
DefinitionThis section has been translated automatically.
Clinical-morphological descriptive name for an acute or chronic dermatitis of different aetiology of the buttock and groin region (but also the axillary region), which used to be called Baboon ( = baboon) syndrome because it reminded of a reddened "monkey's buttocks". The recently used designation "SDRIFE" takes into account that predominantly systemically administered drugs without previous sensitization can cause this flexural dermatitis. SDRIFE typically occurs a few hours to days after application of the drugs in question.
Regardless of its nomenclature, the disease is controversial as an entity in its own right.
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Occurrence/EpidemiologyThis section has been translated automatically.
m>w (Häusermann P et al. 2004)
EtiopathogenesisThis section has been translated automatically.
Originally, "Baboon syndrome" was described as an extensive fixed drug reaction localized to the buttocks, or localization-typical contact allergic eczema with scatter reaction, or hematogenous contact dermatitis. Pustular components have also been described (Magnolo N et al. 2017).
With SDRIFE, the clinical symptoms are narrowed down to a drug-allergic or -toxic trigger. A localized T-cell-mediated reaction of the late type is discussed, although it is unclear why this reaction behaves in a localization-typical manner. This could be a reactivation phenomenon in which a systemic reaction occurs in predisposed areas.
The extent to which there is an association with COVID-19 infection or anti-COVID antiviral therapy (viral infection + drug) remains to be further observed (Chicharro P et al. 2021; Bevilaqua M et al. 2021) .
The following drugs have been described in association with SDRIFE:
LocalizationThis section has been translated automatically.
buttocks, genitals, groin region, axillary region
TherapyThis section has been translated automatically.
Note(s)This section has been translated automatically.
Some authors now consider the term "Baboon syndrome" obsolete. With the acronym "SDRIFE " = symmetrical drug related intertriginous and flexural exanthema, a more precise description of this entity in question was attempted (Wolf R et al. 2015):
- S= symmetrical (symmetrical arrangement of skin manifestations).
- DR= drug related (see below etiopathogenesis)
- I= intertriginous (gluteal, perianal, V-shaped inguinal/thigh)
- F= flexural (involvement of at least one other flexor region)
- E= exanthema (often deep red erythema or plaques)
LiteratureThis section has been translated automatically.
- Andersen KE, Hjorth N, Menne T (1984) The baboon syndrome: systemically-induced allergic contact dermatitis. Contact Dermatitis 10: 97-100
- Bevilaqua M et al (2021) SDRIFE-like rash in COVID-19 patient: drug reaction or another cutaneous manifestation of SARS-CoV-2? Int J Dermatol 60: 884-885.
- Blackmur JP et al (2013) Baboon syndrome: an unusual complication arising from antibiotic treatment of tonsillitis and review of the literature. BMJ Case Rep doi: 10.1136/bcr-2013-201977.
- Cabrera Hernandez V et al (2019) Symmetrical drug-related intertriginous and flexural exanthema due to clindamycin. BMJ Case Rep 12:e230077.
- Chicharro P et al (2021) SDRIFE-like rash associated with COVID-19, clinicopathological correlation. Australas J Dermatol 62: 88-89.
- Erdmann SM et al (2010) Hematogenous contact dermatitis due to food. Allergo J 19: 264-271
- Harde V et al (2011) Baboon syndrome in type IV sensitization to triamcinolone acetonide. Abstract CD 46th DDG Conference: P02/17.
- Haufe, K et al (2013) Unusual clinical presentation of baboon syndrome. derm 19: 197-201.
- Häusermann P et al. (2004) Baboon syndrome resulting from systemic drugs: is there strife between SDRIFE and allergic contact dermatitis syndrome? Contact Dermatitis 51:297-310.
- Herfs H et al. (1993) "Baboon syndrome. A particular manifestation of hematogenous contact reaction. Dermatologist 44: 466-469
- Kick G, Przybilla B (2000) Delayed prick test reaction identifies amoxicillin as elicitor of baboon syndrome. Contact Dermatitis 43: 366-367
- Magnolo N et al.(2017) Pustulobullous variant of SDRIFE (symmetrical drug-related intertriginous andflexural exanthema).J Dtsch Dermatol Ges 15:657-659.
- Nespoulous L et al. (Symmetrical drug-related intertriginous and flexural exanthema (SDRIFE) associated with pristinamycin, secnidazole, and nefopam, with a review of the literature. Contact Dermatitis 79:378-380.
- Proske S et al. (2003) Severe allergic contact dermatitis with generalized spread due to bufexamac presenting as the "baboon" syndrome. Dtsch Med Wochenschr 128: 545-547.
- Weiss JM et al (2001) Reproducible drug exanthema to terbinafine with characteristic distribution of baboon syndrome. Dermatologist 52: 1104-1106
- Wolf R et al (2015) Baboon syndrome and toxic erythema of chemotherapy: Fold (intertriginous) dermatoses. Clin Dermatol 33:462-465.
- Ziemer M (2014) Cutaneous drug reactions of late type. Pathogenesis, clinic and histology. Dermatol 65: 397-408
Incoming links (9)Clindamycin; Codeine; Contact dermatitis haematogenic; COVID-19 and skin; Drug exanthema maculo-papular; Hematogenic contact dermatitis; Hydroxycin; Hypersensitivity; Penicillin allergy;
Outgoing links (10)Allopurinol; Clindamycin; Covid-19; Food allergens; Heparin; Hydroxycarbamide; Immunoglobulins, specific; Peru balsam; Terbinafine; X-ray contrast medium incompatibility;
Please ask your physician for a reliable diagnosis. This website is only meant as a reference.