Vildagliptin-Associated Bullous Pemphigoid: A Case Report

Debanjan Roy; Gunjan Gayen; Sabnam Ara Begum; Sandip Ghosh; Sucheto Talukder; Arisha Sarkar; Shritama Aich

doi:10.18502/ijdo.v16i2.15711

Debanjan Roy Post-Graduate Trainee, Department of Pharmacology, R. G. Kar Medical College and Hospital, Kolkata, India
Gunjan Gayen Post-Graduate Trainee, Department of Pharmacology, R. G. Kar Medical College and Hospital, Kolkata, India
Sabnam Ara Begum Associate Professor, Department of Pharmacology, R. G. Kar Medical College and Hospital, Kolkata, India.
Sandip Ghosh Principal, R.G. Kar Medical College and Hospital, Kolkata, India.
Sucheto Talukder Undergraduate Student (M.B.B.S), R.G. Kar Medical College and Hospital, Kolkata, India.
Arisha Sarkar Undergraduate Student (M.B.B.S), R.G. Kar Medical College and Hospital, Kolkata, India.
Shritama Aich Multidisciplinary Research Unit, R.G. Kar Medical College and Hospital, Kolkata, India.

DOI: https://doi.org/10.18502/ijdo.v16i2.15711

Keywords: Autoimmune, Hemidesmosomes, pruriginous, Bullous, Immune-tolerance, Vildagliptin.

Abstract

Objective: Bullous pemphigoid is a rare autoimmune skin disorder characterized by blistering, urticarial lesions, which are sometimes associated with adverse drug reactions. Vildagliptin is an oral anti-diabetic agent that selectively inhibits the dipeptidyl peptidase-4 (DPP-4) enzyme

Materials and Methods: A 75-year-old female with a known case of type 2 Diabetes Mellitus, hypertension, and hypothyroidism for the last 10 years presented with pruriginous tense bullous skin lesions over her both palms and soles. There was no mucosal involvement. Further interrogation revealed that she started taking Vildagliptin 5 days ago which was prescribed due to high levels of post-prandial blood sugar level despite already intake of Glimepiride-4 mg and Metformin-3 gm.

Results: Vildagliptin was immediately advised to be stopped. She was treated with antihistamines, steroids, and conservative management which led to remission of the blisters

Conclusion: Vildagliptin is the probable causative drug for developing bullous pemphigoid skin lesion which shows temporal association in this case as other concomitant drugs has no direct correlation. Therefore physicians must be aware of this rare life-threatening side effect of this medicine and advice patients to visit the hospital even the slightest cutaneous manifestation. Bullous pemphigoid can result in fatal life-threatening conditions if not treated early.