CASE REPORT: SYMMETRIC FLEXURAL EXANTHEMA TO DICLOFENAC

Abstract

Symmetric intertriginous and flexural exanthema (SDRIFE) is a rare self-limiting drug reaction characteristically affecting the intertriginous areas. The common offending drugs are aminopenicillins, beta-lactam antibiotics, and chemotherapeutic agents.
Here we report a 68-year-old male who developed well defined symmetric erosions involving bilateral axilla, upper and inner thighs and genitalia with the dusky hue of the surrounding skin and mucosal lesions after twelve hours of intake of diclofenac sodium. One year later on re-exposure to the same drug, he developed an exactly similar clinical picture. The patient recovered with hyperpigmentation during both the episodes on withdrawal of the offending drug and administration of systemic steroids. To the best of our knowledge, this is the first report of recurrent SDRIFE to diclofenac sodium with unusual features of erosive lesions , mucosal involvement and the striking resemblance to a fixed drug eruption.
Keywords: Symmetric intertriginous and Flexural exanthema, Fixed drug eruption, Diclofenac sodium