Symmetrical Drug-Related Intertriginous and Flexural Exanthema (SDRIFE): A Case Report

Symmetrical drug-related intertriginous and flexural exanthema (SDRIFE) is an interesting phenomenon of drug response characterized by symmetrical, exuberant skin reactions often seen in flexural and intertriginous areas. This report describes a 35-year-old gentleman with no relevant clinical history who developed SDRIFE subsequent to the use of oral fluconazole. His skin examination showed non-scaly, erythematous to violaceous patches within the genital, antecubital, axillary, neck, and inframammary folds. The diagnosis was made based on the clinical picture. Discontinuation of fluconazole and a tapering course of oral prednisolone led to complete resolution of symptoms. This case underlines the importance of maintaining a low threshold of suspicion for rare drug reactions such as SDRIFE, even with medications that are not commonly viewed as requiring dermatological follow-up, so that the condition can be directly managed and hopefully prevented in the future.