SDRIFE Induced by Tofacitinib

A 19-year-old Indian woman with alopecia subtotalis was treated with tofacitinib, a Janus Kinase inhibitor, resulting in significant hair regrowth in 80% of patches within 1 month. However, she developed a pruritic symmetrical erythematous rash, diagnosed as symmetrical drug-related intertriginous and flexural exanthema (SDRIFE), a rare cutaneous adverse effect. The rash, which began in the axilla and other flexural areas, intensified with continued medication use. Upon discontinuation of tofacitinib and treatment with topical corticosteroids, emollients, and oral antihistamines, the rash resolved. This case, reported to the Pharmacovigilance Programme of India, highlights the potential for SDRIFE as an adverse reaction to tofacitinib, classified as mild and probably preventable.