Systemic inflammatory trunk recurrent acute macular eruption (SITRAME) is an autoinflammatory syndrome of unknown etiology characterized by recurrent episodes of systemic inflammation accompanied by a distinctive nonpruritic, macular eruption involving the trunk in adults. Thus far, the syndrome has not been reported in pediatric patients.

A SITRAME flare typically presents with a rapidly developing eruption of confluent macules forming patches with well-defined borders, predominantly occurring on the trunk. The eruption is asymptomatic but may be accompanied by fever, fatigue, headache, abdominal pain, myalgia, or other flu-like symptoms. Infections, physical exercise, and vaccinations may trigger flares. Flares are often associated with elevated inflammatory markers, such as C-reactive protein (CRP). Episodes are transient, typically lasting for 2-7 days with a median duration of 3 days, and recurrent attacks over years to decades are typical.

The diagnosis is largely one of exclusion, requiring careful evaluation to rule out more common conditions such as infections, malignancies, hematologic disorders, and autoimmune diseases.