Varenicline-induced symmetrical drug-related intertriginous and flexural exanthema

{Table 1} The term SDRIFE that is symmetrical drug-related intertriginous and flexural exanthema was first described by Häusermann et al. in 2004, and five diagnostic criteria were proposed: (1) Exposure to a systemically administered drug either at the first or repeated dose (excluding contact allergens); (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 localization; (4) symmetry of affected areas; and (5) absence of systemic symptoms and signs. [6] In addition, Schlapbach et al. found that granulysin could be induced in vitro in patients with several kinds of cutaneous adverse reaction in addition to Stevens–Johnson syndrome and toxic epidermal necrolysis, such as maculopapular eruption, acute generalized exanthematous pustulosis or fixed drug eruption. [...]we report a rare case of varenicline-induced symmetrical drug-related intertriginous and flexural exanthema; the causality was confirmed by in vitro granulysin assay.