{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T14:23:48Z","timestamp":1790691828004,"version":"4.1.0"},"reference-count":15,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,5,20]],"date-time":"2024-05-20T00:00:00Z","timestamp":1716163200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Contact Dermatitis"],"published-print":{"date-parts":[[2024,8]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Cutaneous manifestations of drug\u2010induced type IV reactions vary widely, with symmetrical drug\u2010related intertriginous and flexural exanthema (SDRIFE) being a less common presentation. Corticosteroids (CS), primarily known for their anti\u2010inflammatory effects, rarely induce hypersensitivity reactions.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n The aim of this case series is to report four cases of SDRIFE following systemic prednisolone therapy and to review existing CS classification proposals to better understand cross\u2010reactivity of CS.<\/jats:p>\n <\/jats:sec>\n \n Patients\/Methods<\/jats:title>\n Patients recruited at a German dermatology centre underwent allergologic evaluation including prick and patch testing with various CS. Positive cases underwent oral challenge testing with alternative agents. The classification systems of Coopman et al. and Baeck et al. were taken into account.<\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n Despite a paucity of literature, CS\u2010induced type IV reactions do occur, including SDRIFE. Classification systems based on chemical structure provide insight into cross\u2010reactivity patterns. Provocation tests with alternative CS highlight the complexity of managing CS hypersensitivity.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n SDRIFE may develop following systemic prednisolone therapy. Classification systems are helpful in understanding cross\u2010reactivity and help in the selection of alternative preparations but are not always reliable. Individualised assessment is crucial for managing CS hypersensitivity, with consideration of alternative agents and emergency use of CS when necessary.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/cod.14594","type":"journal-article","created":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T01:40:35Z","timestamp":1716255635000},"page":"146-151","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Symmetrical drug\u2010related intertriginous and flexural exanthema (\n SDRIFE<\/scp>\n ) after administration of corticosteroids: Case series and review of literature"],"prefix":"10.1111","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9094-4512","authenticated-orcid":false,"given":"Julian","family":"Steininger","sequence":"first","affiliation":[{"name":"Department of Dermatology University Allergy Center, University Hospital Carl Gustav Carus, Technische Universit\u00e4t Dresden Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4411-3088","authenticated-orcid":false,"given":"Andrea","family":"Bauer","sequence":"additional","affiliation":[{"name":"Department of Dermatology University Allergy Center, University Hospital Carl Gustav Carus, Technische Universit\u00e4t Dresden Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6359-5377","authenticated-orcid":false,"given":"Helena","family":"Hasler","sequence":"additional","affiliation":[{"name":"Department of Dermatology University Allergy Center, University Hospital Carl Gustav Carus, Technische Universit\u00e4t Dresden Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8327-8475","authenticated-orcid":false,"given":"Stefan","family":"Beissert","sequence":"additional","affiliation":[{"name":"Department of Dermatology University Allergy Center, University Hospital Carl Gustav Carus, Technische Universit\u00e4t Dresden Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7457-6481","authenticated-orcid":false,"given":"Susanne","family":"Abraham","sequence":"additional","affiliation":[{"name":"Department of Dermatology University Allergy Center, University Hospital Carl Gustav Carus, Technische Universit\u00e4t Dresden Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,5,20]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20100536.1984.tb00343.x"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0105\u20101873.2004.00445.x"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/cup.14090"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20100536.2007.00959.x"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40629\u2010015\u20100052\u20106"},{"issue":"10","key":"e_1_2_10_7_1","first-page":"1995","article-title":"Intravenous corticosteroids: adverse reactions are more variable than expected in children","volume":"25","author":"Klein\u2010Gitelman MS","year":"1998","journal-title":"J 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