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Symmetrical drug-related intertriginous and flexural exanthema due to clindamycin
  1. Virginia Cabrera Hernandez1,
  2. Monica Gonzalez Afonso1,
  3. Ariel Callero Viera1 and
  4. Lidon Martin-Fernandez Martin2
  1. 1 Allergy Department, Hospital Universitario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain
  2. 2 Nursing Department, Hospital Universitario Nuestra Senora de la Candelaria, Santa Cruz de Tenerife, Spain
  1. Correspondence to Dr Ariel Callero Viera, arielcallero{at}


Systemic drug exposure can produce a skin reaction consisting of symmetrical erythema involving the gluteal and intertriginous areas in the absence of systemic involvement. Symmetrical drug-related intertriginous and flexural exanthema (SDRIFE) occurs after systemic exposure to a drug in which the patient was not previously sensitised, either in the first dose or after several doses. The mechanism of SDRIFE is unknown but is hypothesised to be the result of a delayed hypersensitivity response resulting in a cutaneous eruption some days after the exposure to the drug. The diagnosis should be clinical, based on the history and examination, but skin tests can also be performed to confirm sensitisation. But, as always, the gold-standard test is oral provocation. It is important to know this clinical entity to prevent re-exposure to the responsible allergen in the future.

  • skin
  • dermatology
  • unwanted effects / adverse reactions

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  • Contributors ACV: discussed planning, conduct and reporting case. LM-FM: conception and design. VCH and MGA: acquisition of data and analysis and interpretation of data.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.