Baboon syndrome resulting from systemic drugs:: is there strife between SDRIFE and allergic contact dermatitis syndrome?
Baboon syndrome resulting from systemic drugs:: is there strife between SDRIFE and allergic contact dermatitis syndrome?
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DOI：
10.1111/j.0105-1873.2004.00445.x
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发表时间：
2004-11-01
影响因子：
5.5
通讯作者：
Bircher, AJ
中科院分区：
文献类型：
--
作者：
H채usermann, P;Harr, T;Bircher, AJ
术语“狒狒综合征”（BS）是在20年前引入的，用于对全身暴露于接触性过敏原后发生类似狒狒红臀区的特定皮疹的患者进行分类。此后，在全身暴露于β-内酰胺抗生素和其他药物后，也报告了类似的皮疹。除了介绍我们自己的情况下，我们已经审查和特点的药物相关的狒狒综合征（DRBS）的主要临床和组织学方面的出版报告，并比较了这些情况下的主要临床症状，发现在其他不同的药疹。在大约100例已发表的狒狒综合征病例中，有50例被确定为药物引起的。其中，8例为全身性接触性皮炎（SCD）的代表，42例为口服或静脉注射药物全身给药引起药疹的例子。主要临床表现包括臀部区域和弯曲或擦烂褶皱中明显对称的红斑，无任何全身症状和体征。42例中有14例是由阿莫西林引起的，其中30例为男性，潜伏期在暴露后几小时至几天之间。DRBs是一种罕见的，良性的，经常被低估的药疹，具有独特的临床特征。然而，狒狒综合征这个术语并不能反映所有的症状和体征，在伦理和文化上都是有问题的。此外，狒狒综合征在历史上通常等同于既往接触致敏患者中汞诱导的皮疹。对称性药物相关性擦烂性和弯曲性外展，或SDRIFE，特别是指这种药疹的独特临床模式，并提出了以下诊断标准：1）暴露于首次或重复剂量的全身给药药物（不包括接触性过敏原）; 2）臀部/肛周区域的明显分界红斑和/或腹股沟/生殖器周围区域的V形红斑; 3）累及至少一个其他擦破/弯曲部位; 4）受累区域对称; 5）无全身症状和体征。
The term 'baboon syndrome' (BS) was introduced 20 years ago to classify patients in whom a specific skin eruption resembling the red gluteal area of baboons occurred after systemic exposure to contact allergens. Thereafter, similar eruptions have been reported after systemic exposure to beta-lactam antibiotics and other drugs. In addition to the presentation of 2 of our own cases, we have reviewed and characterized the main clinical and histological aspects of published reports of drug-related baboon syndrome (DRBS) and compared the primary clinical signs from such cases to those found in other distinct drug eruptions. Of approximately 100 published baboon syndrome cases, 50 were identified as drug-induced. Of these, 8 were representatives of systemically induced contact dermatitis (SCD), and 42 were examples of drug eruptions elicited by systemic administration of either oral or intravenous drugs. The main clinical findings included a sharply defined symmetrical erythema of the gluteal area and in the flexural or intertriginous folds without any systemic symptoms and signs. 14 of 42 cases were elicited by amoxicillin, 30 of the 42 patients were male, and latency periods were between a few hours and a few days after exposure. DRBS is a rare, prognostically benign and often underdiagnosed drug eruption with distinct clinical features. The term baboon syndrome, however, does not reflect the complete range of symptoms and signs and is ethically and culturally problematic. Moreover, baboon syndrome is historically often equated with a mercury-induced exanthem in patients with previous contact sensitization. Symmetrical drug-related intertriginous and flexural exanthema, or SDRIFE, specifically refers to the distinctive clinical pattern of this drug eruption, and the following diagnostic criteria are proposed: 1) exposure to a systemically administered drug either at the first or repeated dose (excluding contact allergens); 2) sharply demarcated erythema of the gluteal/perianal area and/or V-shaped erythema of the inguinal/perigenital area; 3) involvement of at least one other intertriginous/flexural localization; 4) symmetry of affected areas; and 5) absence of systemic symptoms and signs.