Multidisciplinary Research Unit, R.G. Kar Medical College and Hospital, Kolkata, India.
Abstract: (237 Views)
Objective: Bullous pemphigoid is a rare autoimmune skin disorder characterized by blistering, urticarial lesions, which are sometimes associated with adverse drug reactions.
Vildagliptin is an oral anti-diabetic agent that selectively inhibits the dipeptidyl peptidase-4 (DPP-4) enzyme.
Materials and Methods: A 75-year-old female with a known case of type 2 Diabetes Mellitus, hypertension, and hypothyroidism for the last 10 years presented with pruriginous tense bullous skin lesions over her both palms and soles. There was no mucosal involvement. Further interrogation revealed that she started taking Vildagliptin 5 days ago which was prescribed due to high levels of post-prandial blood sugar level despite already intake of Glimepiride-4 mg and Metformin-3 gm.
Results: Vildagliptin was immediately advised to be stopped. She was treated with antihistamines, steroids, and conservative management which led to remission of the blisters.
Conclusion: Vildagliptin is the probable causative drug for developing bullous pemphigoid skin lesion which shows temporal association in this case as other concomitant drugs has no direct correlation. Therefore physicians must be aware of this rare life-threatening side effect of this medicine and advice patients to visit the hospital even the slightest cutaneous manifestation. Bullous pemphigoid can result in fatal life-threatening conditions if not treated early.
Type of Study:
Research |
Subject:
Special Received: 2023/12/24 | Accepted: 2024/04/8 | Published: 2024/06/21
References
1. Ohnuma K, Dang NH, Morimoto C. Revisiting an old acquaintance: CD26 and its molecular mechanisms in T cell function. Trends in immunology. 2008;29(6):295-301. [
DOI:10.1016/j.it.2008.02.010]
2. Tasanen K, Varpuluoma O, Nishie W. Dipeptidyl peptidase-4 inhibitor-associated bullous pemphigoid. Frontiers in immunology. 2019;10:463593. [
DOI:10.3389/fimmu.2019.01238]
3. Varpuluoma O, Försti AK, Jokelainen J, Turpeinen M, Timonen M, Huilaja L, Tasanen K. Vildagliptin significantly increases the risk of bullous pemphigoid: a Finnish nationwide registry study. Journal of Investigative Dermatology. 2018; 138(7):1659-61. [
DOI:10.1016/j.jid.2018.01.027]
4. Plaquevent M, Tétart F, Fardet L, Ingen-Housz-Oro S, Valeyrie-Allanore L, Bernard P, et al. Higher frequency of dipeptidyl peptidase-4 inhibitor intake in bullous pemphigoid patients than in the French general population. Journal of Investigative Dermatology. 2019;139(4):835-41. [
DOI:10.1016/j.jid.2018.10.045]
5. Miyamoto D, Santi CG, Aoki V, Maruta CW. Bullous pemphigoid. Anais brasileiros de dermatologia. 2019;94:133-46. [
DOI:10.1590/abd1806-4841.20199007]