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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. 1Department of Dermatology and Venerology, Lozano Blesa University Clinical Hospital, Zaragoza, Spain
  2. 2Department 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}outlook.com

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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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Footnotes

  • 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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