Baboon syndrome is a specific exanthema that is caused by certain medications. The disease term is derived from the English word ‘baboon’ for baboon and illustrates the main symptom of the disease. Patients with baboon syndrome develop characteristic redness in the area of the buttocks that also affects the flexures of the joints as well as the genital area.
What is Baboon syndrome?
Baboon syndrome is sometimes referred to by the common abbreviation SDRIFE. The trigger for the condition is usually specific medical agents. Due to the administration of these drugs, individuals develop the typical red coloration. However, these are not substances that are typical contact allergens. Following the ingestion of the medication, reddened areas form on the buttocks, the genitals as well as the groins (medical term “inguinae”). Basically, Baboon syndrome is a so-called erythema. It has a symmetrical form and occurs on both sides. Another characteristic of Baboon syndrome is that it occurs on at least one joint bend in addition to the buttock and genital areas. Other systemic complaints usually do not present with Baboon syndrome. Baboon syndrome was first scientifically described by physicians in 1984. To date, about 100 patients with Baboon syndrome have been registered. In view of the small number of cases, Baboon syndrome is a very rare disease.
Causes
Baboon syndrome develops in some people as a reaction to taking certain medical agents. For example, the substances amoxicillin, ampicillin, metallic nickel, and mesalazine are potential triggers of Baboon syndrome. Heparin, contrast media with iodine content, omeprazole, allopurinol, mercury, terbinafine and cetuximab are also possible causes of Baboon syndrome. In most cases, the typical reactions on the corresponding areas of the skin develop within a few hours to several days after systemic ingestion of the responsible drug. In some patients, the first symptoms do not even appear until three days after administration of the triggering substance. Basically, Baboon syndrome is a special form of contact allergy. Such allergies belong to type IV, which is mediated via the cells. The allergens spread through the blood in the human organism.
Symptoms, complaints, and signs
The characteristic symptoms of Baboon syndrome consist of reddened skin areas on the genitals, buttocks, and one or more flexures of the joint. The redness is symmetrical; moreover, it appears on both sides of the body. The color of the redness resembles those of the natural buttocks of certain baboons. This is also the origin of the name of Baboon syndrome. In some cases, the redness also affects some of the bends of the joints, for example, the groins or the crooks of the arms. The redness is relatively well demarcated from the surrounding areas. Usually, no systemic symptoms other than the reddened skin areas develop in individuals affected with Baboon syndrome.
Diagnosis and course
Patients with the typical signs of Baboon syndrome consult either their general practitioner or, if possible, a dermatologist or allergist immediately. During the initial history taking, the existing complaints are recorded and their time of origin as well as the further circumstances of the initial manifestation are discussed during the patient interview. It is of utmost importance in the diagnosis of Baboon syndrome to identify all medications taken by the patient during a certain period of time and to examine them for their side effects. If the affected person has taken a substance potentially triggering Baboon syndrome, the suspicion of the allergy is considerably strengthened. Clinical examinations initially include visual examinations of the patient and the affected skin areas. In the majority of cases, laboratory blood analyses are used to identify decisive parameters and abnormalities. Obligatorily, the physician also checks the patient’s vital functions such as blood pressure and heart rate. In the next step of the examination, the physician performs a differential diagnosis.This is because the symptoms of numerous other diseases are in part similar to those of Baboon syndrome, so that confusion is possible if care is not taken. For example, the physician has to exclude mycoses, intertrigo, systemic contact dermititis and anal eczema. In addition, the specialist distinguishes Baboon syndrome from toxic shock syndrome and the so-called initial staphylococcal scalded skin syndrome.
Complications
Baboon syndrome is characterized by an acute reddish rash on the buttocks, groin, and genital areas. In addition to the buttocks and genital area, the rash occurs in at least one joint flexure. Mainly the crooks of the arms are affected. Patients feel a slight burning sensation around the affected skin areas. Other systemic complications usually do not occur. Since Baboon syndrome occurs as a direct consequence of taking certain medications or coming into contact with certain substances, individual therapy approaches quickly lead to success after diagnosis. The first symptoms occur within a few hours to three days after systemic ingestion of the triggering medication or contact with substances such as nickel. Therefore, this contact allergy is considered uncomplicated and the symptoms disappear within one to two weeks after discontinuation of the medication or the last contact. Long-term skin redness has not been observed in this contact allergy. Therefore, patients do not have to worry about complications or late effects after treatment. Because Baboon syndrome is very rare and individualized therapeutic approaches are usually prompt, complications have not been documented in patients without treatment.
When should you see a doctor?
Patients with the typical symptoms of Baboon syndrome should consult their primary care physician or a dermatologist or allergist. If there is symmetrical reddening of the skin on the genitals, in the crooks of the joints, or on the buttocks after taking a medication, this indicates at least an allergic reaction that needs to be clarified. A medical professional can then narrow down the cause and diagnose or rule out Baboon syndrome. If the exanthema is diagnosed, treatment of the symptoms should be initiated promptly. In addition to the general practitioner, various internists as well as allergists and dermatologists can be considered for this. Accompanying this, the exact cause of the syndrome must be determined. In most cases it is sufficient to discontinue the responsible preparation and to alleviate the skin changes with the help of general medical measures. Even if no treatment is given for Baboon syndrome, complications are unlikely. Therefore, medical clarification is only necessary for reasons of finding the cause. Only patients with existing skin or immune diseases should have noticeable symptoms treated immediately to avoid problems and interactions.
Treatment and therapy
In principle, Baboon syndrome is a benign disease. In the majority of cases, the erythema regresses within a few weeks once the responsible drug is no longer taken. This usually takes about one or two weeks. To the best of our knowledge, no patients with Baboon syndrome have been observed to suffer long-term from the redness of certain areas of the skin. Usually, the reddened areas fade completely. In case of severe symptoms, drug therapy of Baboon syndrome is possible. This usually involves the use of corticosteroids, which are applied topically. This usually reduces the acute discomfort quickly.
Outlook and prognosis
The outlook for recovery from Baboon syndrome is very good. The disease normally regresses in patients within a few weeks of seeking medical care, and freedom from symptoms occurs. The available medication, when used in an optimal and coordinated manner, provides significant relief of symptoms within the first few days of use. Regular use of the medication eventually leads to complete recovery of the patient. In rare cases, intolerances to containing ingredients of the medicine may occur, which disappear if the treatment plan is changed immediately and the medicine is discontinued. Alternative preparations are available thanks to scientific progress and can be used.Their mode of action to cure Baboon syndrome is also very good. Without medical care, there is also freedom from symptoms. However, the healing process is significantly delayed in most cases. The affected skin areas must be spared and natural products to alleviate the symptoms would also be available. However, if a possible itch is indulged, complications may arise. Germs and pathogens can enter the organism via open wounds on the body, leading to further illnesses. In severe cases, the patient is threatened with blood poisoning, which can have a fatal course.
Prevention
Baboon syndrome can be prevented by means of avoiding the triggering medicinal agents if intolerance is known. Because contact allergy to these substances is not known in all cases, prevention of Baboon syndrome is not possible in all people.
Follow-up
Follow-up care is usually not required for Baboon syndrome. The disease heals completely within a few weeks after discontinuation of the drug involved. However, there is no immunity thereafter. Re-infection is possible. Patients are responsible for preventing this. Triggering substances must be avoided at all costs. Since not all allergens can always be clearly identified, a certain residual risk remains. The right contact person for suspected Baboon syndrome is the dermatologist. He will ask about all medications taken recently and correlate them with the symptoms. Sometimes he also arranges for a blood sample to be taken. Due to the nature of the disease, after discontinuation of the triggering medication, the typical symptoms become weaker and disappear. It is necessary to find another remedy with the same mode of action. This is not always easy. Sometimes reddening of the skin caused by Baboon syndrome remains for weeks. These are not only cosmetic in nature. Bacteria and infections can be transmitted through them. Therefore, as part of the aftercare, it is important to take it easy. The attending physician prescribes ointments and informs about hygiene standards. Because of its antibiotic effect, willow bark is considered a suitable remedy.
What you can do yourself
Baboon syndrome mostly disappears by itself as soon as the responsible medication is discontinued. Nevertheless, some complications may occur, which can be treated with the help of some measures. If the erythema has not subsided after a few days, the affected area must be checked for abnormal changes. Bleeding or infections in the area of the erythema are typical for a severe course. Anyone who notices these symptoms should consult a doctor immediately. In the case of a positive course, it is sufficient to take care of the skin in the affected area. Perfumed or otherwise irritating skin care products should be avoided until the erythema has subsided. The painful erythema is best treated with the prescribed cortisone ointment. If the preparation shows no effect, natural remedies can be tried. Effective for inflammation is, for example, the antibiotic willow bark or the pain-relieving ribwort plantain. Ginseng, echinacea, comfrey and mallow can also be used for erythema. Accompanying this, the affected skin areas must be spared and treated with care. In case of bleeding and inflammation, the responsible physician should be consulted. It is possible that Baboon syndrome is based on a serious disease that must be treated immediately.
