Symmetric drug-related intertriginous and flexural exanthema due to itraconazole: An uncommon side effect of a commonly used drug

Rising trends of symmetrical drug related intertriginous and flexural exanthem due to Itraconazole in patients with superficial dermatophytosis: A case series of 12 patients from eastern part of India

“…3 Authors from this study had previously reported a single case of SDRIFE due to Itraconazole in 2016. 4 In this case series, we have analyzed the various presentations and clinical characteristics of SDRIFE due to Itraconazole, and looked into the possible cause of rise in SDRIFE due to itraconazole. We also advocate the further need of studies to find out incidence of SDRIFE among other ADRs due to itraconazole.…”

Itraconazole‐induced symmetrical drug‐related intertriginous and flexural exanthema (SDRIFE): a rare occurrence

“…To date, there is only a single report of itraconazole-induced SDRIFE in literature. 1 A 45-year-old man presented to us with an intensely pruritic rash over his groin, buttocks, and bilateral axilla without any systemic symptoms for the last 1 week. There was a history of intake of oral itraconazole 100 mg two times daily which he was prescribed for tinea corporis by a local dermatologist 10 days back.…”

“…3 Oral provocation test is positive in most patients, while patch test is positive only in 50% of the cases. 1 SDRIFE is often a self-limiting eruption provided the culprit drug is stopped at the earliest. A short course of oral steroids may hasten recovery.…”

“…Beta-lactam antibiotics such as penicillin and cephalosporins are the most common drugs responsible for SDRIFE. Other drugs include mercury, nickel, heparin, allopurinol, erythromycin, hydroxyurea, pseudoephedrine, codeine, aminophylline, terbutaline, cimetidine, ranitidine, nystatin, fluconazole, barium sulfate, iodinated radiocontrast media, intravenous immunoglobulin, andcetuximab 1,4.…”

“…Fecal occult blood test and celiac disease screening were also negative.Based on these findings, a diagnosis of hematohidrosis was hypothesized and after cardiologic evaluation, the patient was started with propranolol treatment (20 mg/die, then increased to 30 mg/die for initial lack of response) combined with psychological treatment. In two weeks, bleeding frequency significantly improved, with 0-2 episodes occurring per day compared to the initial average of five episodes daily.DiscussionHematohidrosis is an exceptionally rare condition consisting of self-limited episodes with blood discharge through intact skin or mucosa, triggered by stressors, states of anxiety, or physical activity [1][2][3][4]. Bleedings can involve various skin sites, often concentrating on facial and scalp regions, while mucosa is less involved, including oral and nasal cavities.…”