Three decades ago, researchers described an eruption with a very characteristic distribution pattern that was confined to the buttocks and the intertriginous and flexor areas. They gave this reaction pattern one of the most unforgettable names in dermatology, baboon syndrome (BS), due to the characteristic, bright-red, well-demarcated eruption predominantly on the buttocks and genital area, reminiscent of the red bottom of a baboon. The authors described three cases provoked by
ampicillin,
nickel, and
mercury. They were convinced that BS represented a special form of hematogenous or systemic contact-type
dermatitis, but several important papers that appeared during the past decade disagreed and suggested that BS should be distinguished from hematogenous or systemic contact-type
dermatitis. A new acronym, SDRIFE (symmetrical
drug-related intertriginous and flexoral
exanthema), was proposed along with five diagnostic criteria: (1) exposure to a systemically administered
drug at the time of first or repeated doses (contact
allergens excluded), (2) sharply demarcated
erythema of the gluteal/perianal area and/or V-shaped
erythema of the inguinal/perigenital area, (3) involvement of at least one other intertriginous/flexural fold, (4) symmetry of affected areas, and (5) absence of systemic symptoms and signs. Although there are merits to the arguments in favor of SDRIFE, many of us still prefer to use the wittier name baboon syndrome, and even more authors use both terms. We confess that we find it difficult to relinquish the term BS, which has served us so well for years; however, recognition, familiarity, and knowledge of the characteristics of this form of
drug eruption must supersede sentimental attachment to a certain nomenclature and so, however reluctantly, we must embrace change. Another intertriginous
drug eruption is the one induced by
chemotherapy. Toxic
erythema of
chemotherapy (TEC) is a useful clinical term that recently has been introduced to describe this group of
chemotherapy-induced eruptions. This group of overlapping toxic reactions is characterized by areas of painful
erythema often accompanied by
edema usually involving the hands and feet, intertriginous zones (eg, axilla, groin), and, less often, the elbows, knees, and ears. Toxic
erythema of
chemotherapy is briefly discussed.