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Bullous pemphigoid and dipeptidyl peptidase-4 inhibitors: the importance of the pharmacotherapeutic history
  1. Miguel Fernando García-Gil1,
  2. Victoria Lezcano Biosca1,
  3. Mar García García2,
  4. Juan Monte Serrano1,
  5. Beatriz Aldea Manrique1
  1. 1 Department of Dermatology and Venerology, Lozano Blesa University Clinical Hospital, Zaragoza, Spain
  2. 2 Department of Anatomic Pathology, Lozano Blesa University Clinical Hospital, Zaragoza, Spain
  1. Correspondence to Dr Miguel Fernando García-Gil, Department of Dermatology and Venerology, Lozano Blesa University Clinical Hospital, 50009 Zaragoza, Spain; miguelgarciagil{at}

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A 97-year-old man with a history of type II diabetes mellitus was treated with oral antidiabetic agents. He went to the emergency department after the appearance of blister-like itchy lesions on the abdomen and extremities since 2 months.

The examination revealed eczematous lesions on the back, abdomen and extremities along with tense blisters on an erythematous base and serous content (figure 1A).

Figure 1

(A) Tense blisters as well as eczematous lesions on the thigh. (B) Subepidermal blister with inflammatory contents and eosinophils. There is a perivascular and interstitial inflammatory component of lymphocytes and eosinophils in the superficial dermis (HEx10). (C) The direct immunofluorescence study shows linear immunoglobulin G deposits in the epidermal basement membrane. (D) C3 deposits are also seen.

In the blood test carried out, 285 mg/dL glucose and 7.1% eosinophilia stood out, with no associated leucocytosis or other relevant findings. Positive …

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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