Amoxicillin
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Amoxicillin Symmetrical drug-related intertriginous and flexural exanthema: case report A 19-year-old woman developed symmetrical drug-related intertriginous and flexural exanthema (SDRIFE) following drug provocation test of amoxicillin. The woman was referred for investigation of possible penicillin allergy based on a childhood history of rash developing following the amoxicillin treatment. To exclude penicillin allergy, she underwent drug provocation test with a low-risk challenge to oral amoxicillin syrup with a final dose of 786mg with no evidence of type 1 IgE mediated hypersensitivity. After 4 hours, she developed a marked burning sensation over her back and buttocks. An examination showed a maculopapular rash over her lower back and buttocks. Blood tests revealed normal C-reactive protein. Seven days following the initial challenge, the rash remained persistent over her buttocks; however also involved the decollete area and flexural regions over her arms. On the basis of these findings, a diagnosis of SDRIFE (Baboon syndrome) secondary to amoxicillin was made. The woman was treated with unspecified long-acting nonsedating antihistamine and a short course of prednisolone. After 10 to 14 days, her rash resolved. Author comment: "Symmetrical drug-related intertriginous and flexural exanthema has most commonly been described with penicillins used for treatment of infection, but ours is the first case to develop after amoxicillin drug challenge performed to exclude immediate hypersensitivity to penicillins." Arnold DF, et al. Drug hypersensitivity testing: Baboon syndrome precipitated by amoxicillin challenge. Annals of Allergy, Asthma and Immunology 124: 104-106, No. 1, Jan 2020. Available from: URL: http://doi.org/10.1016/j.anai.2019.09.022 803443790 United Kingdom
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Reactions 4 Jan 2020 No. 1785
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