β-内酰胺,尤其是青霉素,可能会引起几种过敏反应。在这种情况下,我们描述了与对称药物相关的三七间性和弯曲性皮疹(SDRIFE)疾病,一例罕见的由阿莫西林/克拉维酸引起的全身性接触性皮炎,需要在鉴别诊断中加以考虑。一名65岁的男性患者因髋部弯曲表面的蓝紫色色素沉着增加而被我们的过敏门诊收治,前臂,腋下,和脖子的后面。该患者正在接受血管紧张素受体阻滞剂(ARB)和氢氯噻嗪利尿剂的组合治疗高血压。该患者三个月前使用了含阿莫西林的抗生素;结果,局部有发红,瘙痒,黑斑没有任何全身症状.同样,该患者报告说,八个月前他使用阿莫西林治疗上呼吸道感染时,他在20天内出现了类似的副作用,并在使用皮质类固醇软膏时康复。由于我们的患者在服用青霉素类抗生素后出现了对称的部位受累,间隔5个月,随后出现了类似的反应,SDRIFE得到了考虑。皮肤穿刺活检的结果确定了狒狒综合征(SDRIFE)。开始使用局部皮质类固醇和抗组胺药治疗。临床上说,SDRIFE的特点是臀部/肛周区域的明显红斑和/或腹股沟/生殖器周围区域的V形红斑,至少一个其他的中间或弯曲区域的对称参与,没有全身体征或症状。应考虑药物可能导致患者弯曲区域红斑爆发的可能性,应建议患者停止服药,不再使用。
β-Lactams, particularly penicillins, may cause several allergic reactions. We described symmetric drug-related intertriginous and flexural exanthema (
SDRIFE) illness in this case, a rare instance of systemic contact dermatitis caused by amoxicillin/clavulanic acid that needs to be considered in the differential diagnosis. A 65-year-old male patient was admitted to our Allergy Outpatient Clinic because of increased blue-purple pigmentation on the flexural surfaces of the hip, forearm, axilla, and posterior face of the neck. The patient was receiving a combination of angiotensin receptor blocker (ARB) and hydrochlorothiazide diuretic medication for hypertension. The patient used an antibiotic containing amoxicillin three months ago; As a result, there was localized redness, itching, and black spotting without any systemic symptoms. Similarly, the patient reported that when he used amoxicillin for an upper respiratory tract infection eight months ago, he experienced similar side effects within 20 days and recovered when he applied corticosteroid ointment. Due to the symmetrical site involvement following the consumption of penicillin group antibiotics with a five-month gap and subsequent comparable reactions in our patient,
SDRIFE was taken into consideration. The results of the skin punch biopsy identified Baboon Syndrome (
SDRIFE). Treatment with topical corticosteroids and antihistamines began. Clinically speaking,
SDRIFE is distinguished by significant erythema of the gluteal/perianal area and/or V-shaped erythema of the inguinal/perigenital area, symmetric involvement of at least one other intertriginous or flexural area, and the absence of systemic signs or symptoms. The possibility that the medication may have contributed to the patient\'s erythematous eruption in the flexural regions should be taken into account, and the patient should be advised to stop taking the medication and not use it again.