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Reexposure to the culprit would be expected to reproduce the same clinical picture If there is any doubt about the diagnosis patch tests can be performed, which are commonly positive Symmetrical drug related intertriginous and flexural exanthema (SDRIFE) (figure 32) A symmetrical erythematous rash affecting the buttocks/natal cleft, peri-anal region or groins , usually along with one or more other flexural sites The latency from drug intake to the onset of SDRIFE ranges from hours to a few days Among the medications causing SDRIFE , beta-lactam antibiotics, especially amoxicillin, are most common, others include cephalosporins, clindamycin, erythromycin, valaciclovir, NSAIDS, codeine, hydrochlorothiazide, terbinafine, cimetidine, nystatin, fluconazole, risperidone, rivastigmine, heparin and pseudoephedrine The reaction improves quickly on withdrawal of the culprit drug Patch tests are positive in up to 50% with SDRIFE Clinical Images Please refer to notes on image rights at bottom of the page with regards to individual image ownership

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Common sites include the abdomen, outer thigh, and lower back flank

10.1016/j.jconrel.2003.12.027 115 WangJ.LeeJ

Ecography 28, 110128