A Case Report of Clozapine-induced Symmetrical Drug-Related Intertriginous and Flexural Exanthema with cross-reactivity between Clozapine and Quetiapine
Introduction Symmetrical Drug-Related Intertriginous and Flexural Exanthema (SDRIFE) is characterised by a distinctive pattern of erythematous and symmetrical rash over the gluteal and intertriginous regions after exposure to certain systemic medications. This is an uncommon condition which has bee...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Cambridge University Press
2023-03-01
|
| Series: | European Psychiatry |
| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933823023106/type/journal_article |
| _version_ | 1797617286719209472 |
|---|---|
| author | S. C. Lim A. Lijo |
| author_facet | S. C. Lim A. Lijo |
| author_sort | S. C. Lim |
| collection | DOAJ |
| description |
Introduction
Symmetrical Drug-Related Intertriginous and Flexural Exanthema (SDRIFE) is characterised by a distinctive pattern of erythematous and symmetrical rash over the gluteal and intertriginous regions after exposure to certain systemic medications. This is an uncommon condition which has been thought to be due to a Type IV delayed hypersensitivity reaction. Literature on clozapine-induced SDRIFE remains scarce, and reports of cross-reactivity among anti-psychotics are limited as well.
Objectives
To present a clinical case of Clozapine-induced SDRIFE with cross-reactivity between Clozapine and Quetiapine.
Methods
We describe a case of a lady with Treatment Resistant Schizophrenia who developed erythematous lesions with desquamation over her skin fold regions and buttocks within two months of Clozapine initiation.
Results
In our case, the lady was diagnosed with SDRIFE secondary to Clozapine. Clozapine was ceased, and the rashes resolved completely within a week. However, her psychiatric condition continued to worsened and she was trialed on Quetiapine. Unfortunately, she developed angioedema of the lips which necessitated a cessation of Quetiapine.
Conclusions
This case report illustrates the importance of recognising this rare condition, which can be readily treated by withdrawal of the culprit drug. Given that Clozapine and Quetiapine are structurally similar and fall under the class of Dibenzodiazepines, physicians should also be aware of the possibility of cross-reactivity among anti-psychotic medications leading to hypersensitive reactions.
Disclosure of Interest
None Declared |
| first_indexed | 2024-03-11T07:53:40Z |
| format | Article |
| id | doaj.art-8ed024fd1d6e46c88f4734e64b17cebc |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-03-11T07:53:40Z |
| publishDate | 2023-03-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-8ed024fd1d6e46c88f4734e64b17cebc2023-11-17T05:06:19ZengCambridge University PressEuropean Psychiatry0924-93381778-35852023-03-0166S1087S108810.1192/j.eurpsy.2023.2310A Case Report of Clozapine-induced Symmetrical Drug-Related Intertriginous and Flexural Exanthema with cross-reactivity between Clozapine and QuetiapineS. C. Lim0A. Lijo1Psychiatry, Institute of Mental Health, SingaporePsychiatry, Institute of Mental Health, Singapore Introduction Symmetrical Drug-Related Intertriginous and Flexural Exanthema (SDRIFE) is characterised by a distinctive pattern of erythematous and symmetrical rash over the gluteal and intertriginous regions after exposure to certain systemic medications. This is an uncommon condition which has been thought to be due to a Type IV delayed hypersensitivity reaction. Literature on clozapine-induced SDRIFE remains scarce, and reports of cross-reactivity among anti-psychotics are limited as well. Objectives To present a clinical case of Clozapine-induced SDRIFE with cross-reactivity between Clozapine and Quetiapine. Methods We describe a case of a lady with Treatment Resistant Schizophrenia who developed erythematous lesions with desquamation over her skin fold regions and buttocks within two months of Clozapine initiation. Results In our case, the lady was diagnosed with SDRIFE secondary to Clozapine. Clozapine was ceased, and the rashes resolved completely within a week. However, her psychiatric condition continued to worsened and she was trialed on Quetiapine. Unfortunately, she developed angioedema of the lips which necessitated a cessation of Quetiapine. Conclusions This case report illustrates the importance of recognising this rare condition, which can be readily treated by withdrawal of the culprit drug. Given that Clozapine and Quetiapine are structurally similar and fall under the class of Dibenzodiazepines, physicians should also be aware of the possibility of cross-reactivity among anti-psychotic medications leading to hypersensitive reactions. Disclosure of Interest None Declaredhttps://www.cambridge.org/core/product/identifier/S0924933823023106/type/journal_article |
| spellingShingle | S. C. Lim A. Lijo A Case Report of Clozapine-induced Symmetrical Drug-Related Intertriginous and Flexural Exanthema with cross-reactivity between Clozapine and Quetiapine European Psychiatry |
| title | A Case Report of Clozapine-induced Symmetrical Drug-Related Intertriginous and Flexural Exanthema with cross-reactivity between Clozapine and Quetiapine |
| title_full | A Case Report of Clozapine-induced Symmetrical Drug-Related Intertriginous and Flexural Exanthema with cross-reactivity between Clozapine and Quetiapine |
| title_fullStr | A Case Report of Clozapine-induced Symmetrical Drug-Related Intertriginous and Flexural Exanthema with cross-reactivity between Clozapine and Quetiapine |
| title_full_unstemmed | A Case Report of Clozapine-induced Symmetrical Drug-Related Intertriginous and Flexural Exanthema with cross-reactivity between Clozapine and Quetiapine |
| title_short | A Case Report of Clozapine-induced Symmetrical Drug-Related Intertriginous and Flexural Exanthema with cross-reactivity between Clozapine and Quetiapine |
| title_sort | case report of clozapine induced symmetrical drug related intertriginous and flexural exanthema with cross reactivity between clozapine and quetiapine |
| url | https://www.cambridge.org/core/product/identifier/S0924933823023106/type/journal_article |
| work_keys_str_mv | AT sclim acasereportofclozapineinducedsymmetricaldrugrelatedintertriginousandflexuralexanthemawithcrossreactivitybetweenclozapineandquetiapine AT alijo acasereportofclozapineinducedsymmetricaldrugrelatedintertriginousandflexuralexanthemawithcrossreactivitybetweenclozapineandquetiapine AT sclim casereportofclozapineinducedsymmetricaldrugrelatedintertriginousandflexuralexanthemawithcrossreactivitybetweenclozapineandquetiapine AT alijo casereportofclozapineinducedsymmetricaldrugrelatedintertriginousandflexuralexanthemawithcrossreactivitybetweenclozapineandquetiapine |