A case of dipeptidyl‐peptidase 4 inhibitor‐associated pemphigoid nodularis

Tahara, Jumpei; Ono, Sachiko; Nomura, Takashi; Kaku, Yo; Egawa, Gyohei; Dainichi, Teruki; Izumi, Kiyotaka; Nishie, Wataru; Honda, Tetsuya; Kabashima, Kenji

doi:10.1111/ijd.15458

Cited by 4 publications

(5 citation statements)

References 5 publications

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“…The etiology of PN is completely unknown, though the disease may be caused by drugs, like nifedipine, etanercept, dipeptidyl-peptidase 4 inhibitor, psoralens, and PUVA ( 20 – 24 ). Interestingly, there are a few reports on PN coexisting with rheumatoid arthritis, lichen planus, psoriasis, or diabetes—diseases that are pruritic ( 20 , 22 , 24 – 30 ). It is highly likely that chronic, severe itching in these cases led to the damage of BMZ and exposition of its antigens and subsequently to the PN development.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Pemphigoid Nodularis—Five Patients With Many Years of Follow-Up and Review of the Literature

et al. 2022

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Pemphigoid nodularis is a rare form of pemphigoid that joins the clinical picture of prurigo nodularis and the immunological features of bullous pemphigoid, which is therapeutically challenging. Here, we analyze five female patients with a long-lasting course of nodular pemphigoid in terms of clinical and immunological characteristics and therapy. All the patients fulfilled clinical and immunological criteria of nodular pemphigoid. We applied numerous techniques allowing the proper diagnosis: direct and indirect immunofluorescence, salt split skin, ELISA, BIOCHIP, and fluorescence overlay antigen mapping using laser scanning confocal microscopy. Our study showed that 4 of 5 patients fulfilled the clinical and immunological criteria of nodular bullous pemphigoid. Two out of 4 patients presented exclusively nodular lesions; in the other two patients, blisters and erythematous lesions preceded prurigo-like lesions by a few years. The remaining patient had clinical and immunological criteria of nodular mucous membrane pemphigoid, presenting oral erosions, scarring conjunctivitis, and numerous disseminated nodules on the skin. All the patients were treated with multiple medicines; however, it was observed that the use of clobetasol propionate on the entire body plus antidepressants best controlled the disease. Pemphigoid nodularis mainly occurs in elderly women. In cases with coexisting psychological problems, antidepressants should be considered as an important complementary therapy to the basic one with clobetasol propionate.

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Section: Discussionmentioning

confidence: 99%

Case Report: Pemphigoid Nodularis—Five Patients With Many Years of Follow-Up and Review of the Literature

et al. 2022

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“…Autoantibodies mainly target the NC16a domain of BP180 in conventional BP. However, in BP and its subtypes that are induced by DPP-4 inhibitors, it is different, and autoantibodies also work against other domains of BP (e.g., LAD1) [ 14 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…The first case report of the association between gliptins and the occurrence of BP was diagnosed in 2011 by Skandalis et al [ 13 ]. Recently, few articles have been published about the impact of DPP-4 inhibitors on rare variants of BP such as mucous membrane pemphigoid (MMP, cicatricial pemphigoid) and pemphigoid nodularis [ 12 , 14 , 15 ]. This case series aimed to report a possible association of rare forms of BP: MMP, pemphigoid nodularis, and linear IgA bullous dermatosis (LABD), with gliptins use.…”

Section: Introductionmentioning

confidence: 99%

Dipeptidyl-Peptidase 4 Inhibitor-Induced Variants of Bullous Pemphigoid: A Case Series of Four Patients

et al. 2022

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Bullous pemphigoid is the most common acquired bullous disease with an autoimmune basis and a tendency to involve mostly old people. By rising incidence of diabetes all over the world, consumption of antidiabetes medications has also increased. One of the most used antidiabetes drugs is gliptin family (dipeptidyl-peptidase 4 inhibitor). Recently, this class of oral antidiabetic agents showed a correlation with the occurrence of bullous pemphigoid and its subtypes, including mucous membrane pemphigoid and pemphigoid nodularis. We are reporting a case series of 4 diabetes patients that we diagnosed with bullous pemphigoid subtypes (mucous membrane pemphigoid, pemphigoid nodularis, and its rarest subtype, linear IgA bullous dermatosis) after taking different drugs of gliptin family.

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“…U innego chorego zmiany prawdopodobnie zostały wywołane w wyniku stosowania nifedypiny z powodu nadciśnienia tętniczego [17]. Opisano również jeden przypadek wystąpienia pemfigoidu guzkowego u pacjenta leczonego inhibitorem dipeptydylopeptydazy 4 (DPP-4) z powodu cukrzycy typu 2 [18].…”

Section: Discussionunclassified

“…In another patient, changes were probably caused by the use of nifedipine due to arterial hypertension [17]. One case of nodular pemphigoid was also reported in a patient treated with a dipeptidyl peptidase 4 (DPP-4) inhibitor due to type 2 diabetes [18].…”

Section: Opisy Przypadkówmentioning

confidence: 98%

Pemphigoid nodularis – diagnostic challenges

Grzeszczuk¹,

Woźniacka²,

Żebrowska³

et al. 2022

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Introduction: Bullous pemphigoid is an autoimmune bullous disease that occurs most often in old age. The nodular form of pemphigoid may mimic other dermatoses, but also coexist with them, which causes diagnostic and therapeutic difficulties. Case reports: We present cases of two women (81-year-old and 67-year--old) with a several year history of polymorphic lesions who were initially diagnosed as nodular prurigo. At that time both patients were treated with phototherapy with good tolerance and improvement. During the next courses of UVB-NB irradiation, the condition of their skin deteriorated significantly. Direct immunofluorescence and indirect immunofluorescence studies identified pemphigoid. The initiated pharmacological treatment with methotrexate and systemic glucocorticosteroids resulted in a significant clinical improvement. Conclusions: Presented cases draw attention to the atypical clinical presentation and the impact of UVB-NB phototherapy on the appearance of the first symptoms of pemphigoid.

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A case of dipeptidyl‐peptidase 4 inhibitor‐associated pemphigoid nodularis

Cited by 4 publications

References 5 publications

Case Report: Pemphigoid Nodularis—Five Patients With Many Years of Follow-Up and Review of the Literature

Case Report: Pemphigoid Nodularis—Five Patients With Many Years of Follow-Up and Review of the Literature

Dipeptidyl-Peptidase 4 Inhibitor-Induced Variants of Bullous Pemphigoid: A Case Series of Four Patients

Pemphigoid nodularis – diagnostic challenges

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