2020 Volume 37 Issue 5 Pages 662-667
We describe 8 patients with bullous pemphigoid (BP) who underwent dialysis. All patients underwent hemodialysis for the management of diabetic nephropathy and received a dipeptidyl peptidase-4 (DPP-4) inhibitor. Only one patient continued to use a DPP-4 inhibitor. Systemic steroids were administered in 7 of the 8 cases, one of which required plasma exchange. Considering clinical course and laboratory data, our study perphaps included patients with the usual form of BP, those with DPP-4 inhibitor-induced BP, and those with dialysis-induced BP. Comparing past literatures, we considered that BP that develops during dialysis might show a more severe presentation. BP secondary to DPP-4 inhibitors usually improves after discontinuing the oral administration of these agents, and many patients do not require oral administration of steroids. However, BP with DPP-4 inhibitor that develops during dialysis may include these 3 types as described above. Oral steroids should be considered in patients with BP who do not improve after discontinuing DPP-4 inhibitor administration.
