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J Clin Med. 2021 Apr 28;10(9). doi: 10.3390/jcm10091916.

Clinical, Laboratory and Histological Features of Dipeptidyl Peptidase-4 Inhibitor Related Noninflammatory Bullous Pemphigoid.

Journal of clinical medicine

Ágnes Kinyó, Anita Hanyecz, Zsuzsanna Lengyel, Dalma Várszegi, Péter Oláh, Csaba Gyömörei, Endre Kálmán, Tímea Berki, Rolland Gyulai

Affiliations

  1. Department of Dermatology, Venereology and Oncodermatology, University of Pécs Medical School Clinical Centre, H7632 Pécs, Hungary.
  2. Department of Pathology, University of Pécs Medical School Clinical Centre, H7632 Pécs, Hungary.
  3. Department of Immunology and Biotechnology, University of Pécs Medical School Clinical Centre, H7632 Pécs, Hungary.

PMID: 33925042 PMCID: PMC8125701 DOI: 10.3390/jcm10091916

Abstract

Bullous pemphigoid (BP) is an autoimmune blistering disease of elderly patients that has shown increasing incidence in the last decades. Higher prevalence of BP may be due to more frequent use of provoking agents, such as antidiabetic dipeptidyl peptidase-4 inhibitor (DPP4i) drugs. Our aim was to assess DPP4i-induced bullous pemphigoid among our BP patients and characterize the clinical, laboratory and histological features of this drug-induced disease form. In our patient cohort, out of 127 BP patients (79 females (62.2%), 48 males (37.7%)), 14 (9 females and 5 males) were treated with DPP4i at the time of BP diagnosis. The Bullous Pemphigoid Disease Area Index (BPDAI) urticaria/erythema score was significantly lower, and the BPDAI damage score was significantly higher in DPP4i-BP patients compared to the nonDPP4i group. Both the mean absolute eosinophil number and the mean periblister eosinophil number was significantly lower in DPP4i-BP patients than in nonDPP4i cases (317.7 ± 0.204 vs. 894.0 ± 1.171 cells/μL,

Keywords: DPP4; bullous pemphigoid; dipeptidyl peptidase-4 inhibitor; eosinophil; gliptin

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