[Symmetrical flexural and intertriginous rash related to corticosteroids]

Baboon syndrome is a rare disease characterized by well-defined purpuric skin eruptions in the gluteal and intertriginous areas, like those seen in red-rumped baboons. A new acronym, SDRIFE (drug-related symmetric intertriginous and flexural rash), has been proposed to better define the disease.

A 68-year-old male patient, with no relevant medical history, presented to the Emergency Department with acute respiratory distress. He was administered parenteral hydrocortisone without incident. He was prescribed oral deflazacort for home use, and two hours after taking the first tablet, a skin eruption appeared in the bilateral inguinal region. Diprogenta (betamethasone/gentamicin cream) was applied topically, and one hour after application, the rash spread to the inner thighs and lower abdomen, accompanied by nausea and a fever of 40°C. The patient was evaluated at home and given saline solution and antipyretics, which reduced the fever. The skin symptoms gradually resolved, leaving a residual hyperpigmented lesion. Five years prior, the patient reported generalized urticarial symptoms one hour after administration of parenteral methylprednisolone. Patch tests with corticosteroids were positive for budesonide and hydrocortisone 17-butyrate. A controlled exposure test with deflazacort showed good tolerance.

We emphasize the importance of studying these types of patients and seeking alternatives to corticosteroids for future prescription, given their widespread use in medicine.