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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11616907PMC
http://dx.doi.org/10.4103/idoj.idoj_814_23DOI Listing

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This case report describes a 40-year-old male patient who developed symmetrical drug-related intertriginous and flexural exanthema after taking amoxicillin. Initial allergy testing showed negative intradermal tests, but subsequent drug provocation tests with amoxicillin and penicillin were positive, indicating cross-reactivity between these β-lactam antibiotics. Notably, following the final provocation test, the intradermal test with penicillin turned positive, demonstrating a flare-up phenomenon.

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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.

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A rare long-term side effect of COVID-19 vaccines: Symmetrical drug-related intertriginous and flexural exanthema-like reaction SDRIFE and potential immunogens for delayed type hypersensitivity reactions.

Int Immunopharmacol

January 2025

Ege University, Faculty of Medicine, Department of Pulmonary Medicine, Immunology and Allergy, Laboratory of Occupational/Environmental Respiratory Diseases and Asthma, 35100 Izmir, Türkiye; EgeSAM (Ege University Translational Pulmonary Research Center), 35100 Izmir, Türkiye. Electronic address:

Background: Symmetrical drug-related intertriginous and flexural exanthema (SDRIFE) is an important clinical entity that is rare and may develop with a Type IV delayed type hypersensitivity immune response to drug antigens. The incidence and characteristics of SDRIFE attributed to COronaVIrus Disease of 2019 (COVID-19) vaccines remain unclear, this issue requires further elucidation.

Objective: We aim to investigate the vaccine-related-SDRIFE and potential immunogens of COVID-19 vaccines through a literature review accompanied by a real case.

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