Common drug, uncommon crisis: Symmetrical drug-related intertriginous and flexural exanthema triggered by ceftriaxone

Symmetrical drug-related intertriginous and flexural exanthema (SDRIFE) is a rare type IV delayed hypersensitivity drug reaction characterized by symmetrical erythematous pruritic eruptions predominantly involving the gluteal and intertriginous regions and is most commonly seen in adult males. We report the case of a 42-year-old man who developed a progressive, intensely pruritic erythematous rash predominantly over the flexural and intertriginous areas following the administration of injection ceftriaxone after umbilical herniorrhaphy. Systemic examination was normal, and the patient fulfilled the five-point diagnostic criteria for SDRIFE. Ceftriaxone was withdrawn, and the patient was treated with oral corticosteroids, antihistamines, and emollients, following which the lesions resolved with exfoliation. This case highlights an uncommon adverse cutaneous drug reaction associated with a commonly used antibiotic and emphasizes the importance of early recognition and prompt withdrawal of the offending agent.