ABSTRACT
Symmetrical drug-related intertriginous and flexural exanthema (SDRIFE) is a benign, self-limited, immune-mediated, symmetric erythematous rash involving the buttocks and other intertriginous/flexural areas, observed after systemic exposure to a drug in an individual with or without prior sensitization. We present a 70-year old patient, who presented SDRIFE after the administration of piperacillin-tazobactam which improved rapidly after its suspension.
El exantema intertriginoso y flexural simétrico relacionado con fármacos (SDRIFE, por su sigla en inglés) es una erupción eritematosa simétrica, inmunomediada, benigna y autolimitada, que compromete glúteos y otras áreas intertriginosas, flexurales o ambas, y que se observa luego de la exposición sistémica a un fármaco en un individuo con sensibilización previa o sin ella. Se comenta el caso clínico de un paciente de 70 años de edad, que presentó SDRIFE posterior a la administración de piperacilina-tazobactam y que mejoró rápidamente luego de su suspensión.
Subject(s)
Exanthema , Drug Eruptions , beta-Lactams , Dermatitis , Piperacillin, Tazobactam Drug Combination , IntertrigoABSTRACT
Resumen Es una enfermedad poco frecuente, descripta en 1992 por Moulin, que se presenta entre los 6 y los 20 años de edad, caracterizada por bandas hiperpigmentadas atróficas de distribución blaschkoide, localizadas principalmente en tronco, unilaterales, que no son precedidas por inflamación o cambios esclerodérmicos, induración ni adherencias a planos profundos. En general es una afección autolimitada, cuyos tratamientos resultan ineficaces. Presentamos el caso de un niño de 12 años, con lesiones en tronco compatibles con el diagnóstico de Atrofodermia lineal de Moulin (ALM).
Abstract It is a disease not very frequent, described in 1992 by Moulin, which occurs between 6 and 20 years of age, characterized by hyperpigmented atrophic bands distribution blaschokoide, mainly located in trunk, unilateral, that are not preceded by inflammation or changes sclerodermal, induration, or adhesions to deep. It is a self-limited condition, whose treatments are ineffective. We present the case of a boy, 12 years old, with atrophic, hyperpigmented and asymptomatic plates, distributed from the left mammary region to the homolateral back, following the lines of Blaschko. Refers that is started as a hyperpigmented macula and in recent years it has been atrophying, it is not accompanied by any symptomatology, and was not preceded by inflammatory. We performed laboratory test with complete blood count, renal function, liver function and antibody titers, which were normal; and incisional biopsy by punch, that reported, for a sample stained with hematoxylin-eosin, epidermis of variable thickness, canned, no cellular atypia or disorders madurativos. Dermis impresses discreetly thickened, with homogenization of collagen. Slight perivascular inflammatory infiltrate. With clinical and anatomopathology we arrive at the diagnosis of Linear atrophoderma of Moulin.