The case of a 12-year-old patient is presented, who 5 hours after the application of a topical polyvalent presents an increase in volume at the level of the penis and scrotum, presenting with erythema in flexural areas of the groin, armpit, back of the feet and marked erythema symmetrical in buttocks with pasty skin, referring to intense itching on a 9/10 scale in the lesions. In laboratory tests hemogram without leukocytosis and eosinophils 18%. Normal testicular echo-Doppler. Topical corticosteroid and prednisone were indicated, with remission of pruritus and erythema, being discharged 6 days later. With little desquamation in the buttocks, due to meeting the criteria for drug exposure, V-shaped erythema, flexural compromise, absence of systemic repercussion and symmetric involvement is reported as a drug-related symmetric intertriginous flexural rash (SDRIFE).

Acute generalized exanthematic pustulosis (PEGA) is a rare dermatological pathology characterized by the sudden and generalized appearance of multiple, sterile, non-follicular, punctate pustules on an erythematous and edematous base. It is frequently triggered by drugs, among which antibiotics stand out. We present the case of a 40-year-old male patient who was admitted to the emergency room due to abdominal pain síndrome, to rule out intra-abdominal tumor pathology, initially indicating ceftriaxone and metronidazole. The next day, he was re-admitted to the emergency room, finding, after emergency surgery, acute appendicitis complicated with intestinal perforation, for which they rotated the antibiotic therapy to imipenem-cilastatin + metronidazole. At the next 48 hours, he presents generalized erythema and some small pustules and microvesicles in the thoracic region, upper extremities ...