Symmetrical drug-related intertriginous and flexural exanthema (Baboon syndrome) associated with Infliximab: a case-based review.

Background: SDRIFE is a rare cutaneous eruption characterized by symmetrical intertriginous dermatitis, caused by delayed Type-IV immune reaction, with several reported drug-triggers. Objective: We present a case of SDRIFE associated with infliximab in a 70-year-old female with rheumatoid arthritis, and review cases of SDRIFE associated with TNF-inhibitors. Methods: A literature review about SDRIFE cases associated with TNF-inhibitors was performed. Articles published in English from inception to January 6th, 2022, restricted to humans, and directly related to this review were included. Results: Ours is the third reported case of SDRIFE associated with TNF-inhibitors, and second with infliximab. SDRIFE can occur anytime during treatment with TNF-inhibitors, and presents with similar clinical and histopathological features as SDRIFE secondary to other drugs. No systemic manifestations have been reported, and the rash resolves after discontinuation of the TNF-inhibitor without any long-term sequelae. Conclusion: SDRIFE is benign, and an accurate diagnosis and discontinuation of the responsible drug remain the cornerstone of management.