2022 Volume 21 Issue 3 Pages 170-174
An 84-year-old man with type 2 diabetes mellitus who had been taking oral dipeptidyl peptidase-4 inhibitor for one year presented with multiple blisters. At the time of his first visit, he had blisters with crusts and erosions on his trunk and left upper arm. Based on clinical course, histopathological examination, and serological studies, he was diagnosed as dipeptidyl peptidase-4 inhibitor-associated bullous pemphigoid. His symptoms had improved completely after discontinuation of dipeptidyl peptidase-4 inhibitor, but relapsed shortly after. Anti-BP180NC16a antibody, which was negative at firstvisit, was confirmed to be positive, and systemic administration of glucocorticoid was required. Dipeptidyl peptidase-4 inhibitor-associated bullous pemphigoid is generally considered to be mild. However, it is necessary to recognize the possibility of severe or refractory disease due to possible epitope spreading after the discontinuation of dipeptidyl peptidase-4 inhibitors. Skin Research, 21 : 170-174, 2022
