Systemic contact dermatitis (SCD) is a type of contact hypersen-sitivity reaction induced by ingestion or other systemic exposure to a contact allergen in an already sensitized person. Usually the initial sensitizing exposure has happened by topical application, but reexposure by the oral, intravenous, or inhalation routes can cause SCD. It appears that both humoral and cellular immune responses are involved in this situation. Baboon syndrome may be seen as a particular form of SCD, with a distribution pattern confined to the intertriginous areas and with nickel, mercury, and drugs acting as inducers. The designation baboon syndrome, which emerged from the characteristic, bright red, well-demarcated eruption predominantly located on the buttocks and genital area (reminiscent of the red bottom of the baboon), has recently been replaced by the term symmetrical drug-related intertriginous and flexural exanthema (SDRIFE), which refers to the distinctive clinical pattern of this drug eruption. Several diagnostic criteria have been 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 or perianal area and/or V-shaped erythema of the inguinal or perigenital area; (3) involvement of at least 1 other intertriginous or flexural localization; (4) symmetry of affected areas; and (5) absence of systemic symptoms and signs.
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