अमूर्त

Case report: Alogliptin induced bullous pemphigoid

Syed Jalali*, Francesc Valenti

Evidence has been growing over the significant association between treatment with Dipeptidyl Peptidase 4 inhibitors (DPP-4i) and the development of Bullous Pemphigoid (BP). At present, the mechanism is not clearly understood; however, several possible theories have been proposed, including inhibition of cell surface Plasminogen receptors resulting in over-expression of antigens within the skin basement membrane and increased activity of Caspase-1 pathways in the skin. Variability of reporting of BP between different DPP-4i has been attributed to differences in volume distribution and selectivity of sub-classes of structurally similar DPP. In this case report, we present a case of a diabetic patient seen in a community dermatology clinic with Alogliptin induced BP following a recent change from their previous long term treatment with an alternative DPP-4i. This particular case also deviated from previous reports of DPP-4i induced BP of a noninflammatory variant with greater mucosal involvement.