title: Zoledronic acid-associated symmetrical drug-related intertriginous and flexural exanthema (SDRIFE): report of baboon syndrome in a woman with recurrent metastatic breast cancer after receiving zoledronic acid.
abstract: BACKGROUND
  Baboon syndrome is a distinctive skin reaction in which the patient typically develops erythematous buttocks that appear similar to those of a baboon. The non-contact allergenic variant of baboon syndrome is also referred to as symmetrical drug-related intertriginous and flexural exanthema (SDRIFE). Zoledronic acid is a bisphosphonate that is used in patients with metastatic cancer to prevent bone complications.
  
  
  OBJECTIVE
  Zoledronic acid-associated baboon syndrome is described in a woman with recurrent metastatic breast cancer.
  
  
  METHODS
  PubMed was used to search the following terms, separately and in combination: baboon syndrome, breast cancer, symmetrical drug-related intertriginous and flexural exanthema, and zoledronic acid. All papers were reviewed and relevant manuscripts, along with their reference citations, were evaluated.
  
  
  RESULTS
  Zoledronic acid has infrequently been associated with mucocutaneous adverse reactions. However, baboon syndrome has not previously been observed in patients receiving zoledronic acid. The reported woman developed baboon syndrome after her initial exposure to zoledronic acid.
  
  
  CONCLUSIONS
  Non-contact allergenic drug-induced baboon syndrome has most commonly been associated with antibiotics such as beta-lactams and penicillins. Zoledronic acid-associated baboon syndrome has not previously been observed in cancer patients. Baboon syndrome (SDRIFE variant) was observed in a woman with recurrent metastatic breast cancer after her first exposure to zoledronic acid. In summary, SDRIFE can occur in oncology patients receiving zoledronic acid and zoledronic acid should be added to the list of medications associated with the potential to cause non-contact allergenic drug-induced baboon syndrome.
authors.affiliation: University of California San Diego.
authors.forename: Philip R
authors.initials: PR
authors.lastname: Cohen
mesh_terms: D001132:Arm; D001365:Axilla; D050071:Bone Density Conservation Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000188:drug therapy / Q000556:secondary*; D001943:Breast Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000628:therapy; D002081:Buttocks; D018270:Carcinoma, Ductal, Breast / Q000188:drug therapy / Q000556:secondary* / Q000628:therapy; D018275:Carcinoma, Lobular / Q000188:drug therapy / Q000556:secondary* / Q000628:therapy; D003131:Combined Modality Therapy; D004164:Diphosphonates / Q000009:adverse effects* / Q000627:therapeutic use; D003875:Drug Eruptions / Q000209:etiology*; D004890:Erythema / Q000139:chemically induced*; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000009:adverse effects* / Q000627:therapeutic use; D007402:Intertrigo / Q000139:chemically induced*; D008175:Lung Neoplasms / Q000556:secondary; D008875:Middle Aged; D018198:Mixed Tumor, Malignant / Q000188:drug therapy / Q000556:secondary* / Q000628:therapy; D013577:Syndrome; D000077211:Zoledronic Acid
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid