Symmetrical drug-related intertriginous and flexural exanthema after coronary artery angiography

✍ Scribed by Sara Thierman; R. Sharon Chinthraja

• Book ID: 102339642
• Publisher: John Wiley and Sons
• Year: 2009
• Tongue: English
• Weight: 63 KB
• Volume: 4
• Category: Article
• ISSN: 1553-5592
• DOI: 10.1002/jhm.420

✦ Synopsis

A 57-year-old woman developed a pruritic rash 6 hours after undergoing coronary angiography. On exam, symmetrical, eczematous plaques were noted in her bilateral groin (Figure 1), buttocks, axillae (Figure 2), and the intertriginous folds of her breasts. No palmar, plantar, or mucosal lesions were noted and laboratory tests were normal. This patient presents with symmetrical drug-related intertriginous and flexural exanthema (SDRIFE) secondary to iodine-based contrast dye. It is a type IV hypersensitivity reaction most often reported to nickel, mercury, and systemic antibiotics, although previous sensitization is often unknown. Also called baboon syndrome because its distribution mimics the pink bottom of a baboon, SDRIFE appears hours to days after exposure to the offending agent. The unusual distribution may be explained by high concentrations of the allergen in sweat. Resolution is typical with discontinuation of the offending drug, although antihistamines, topical steroids, and possibly oral steroids may be useful adjuncts.