Symmetrical drug-related intertriginous and flexural exanthema (Baboon syndrome) associated with infliximab.

Background: Symmetrical drug related intertriginous and flexural exanthema (SDRIFE or Baboon syndrome) is a symmetrical contact dermatitis on inverse regions of the body. The disorder is easily differentiated from other drug eruptions by its typical appearance and lack of other concurrent findings.

Observation: A 50-year-old male patient presented to our clinic complaining of a rash that had developed two days after the tenth infliximab infusion for psoriasis and reoccurred after consecutive infusions. The physical examination revealed a bilateral intergluteal, inguinal, abdominal, axillary, antecubital and neck region macular erythematous rash. There were no other systemic findings. The laboratory values were within normal range. The patient was diagnosed with symmetrical drug-related intertriginous and flexural exanthema associated with infliximab treatment based on dermatological findings, histopathology and the results of the provocation test. The lesions resolved permanently after the patient was swiched from infliximab to adalimumab.

Conclusion: Various cutaneous adverse events of anti-tumor necrosis factor alpha treatment have already been reported. The increased use of these agents can lead to a wider variety of drug-induced skin lesions, such as the reported Baboon syndrome.