Title : Gliptin-Induced dermatoses: A case series
Abstract:
Introduction: Gliptins are dipeptidyl peptidase-4 (DPP-4) inhibitors, which are frequently prescribed for the management of type 2 diabetes mellitus. These medications, while effective, have been associated with a range of cutaneous adverse effects, potentially influencing patient outcomes and treatment decisions. Though bullous pemphigoid is the most commonly described skin condition associated with gliptin use, our observations include other morphologically varied dermatoses, necessitating comprehensive evaluation and causality assessment using Naranjo scoring.
Objectives:
1) To examine the occurrence and clinical characteristics of potential gliptin-induced cutaneous disorders and perform necessary investigations to confirm diagnoses.
2) To determine the probability of these dermatological adverse events being induced by gliptins, using the Naranjo scoring scale.
Case History: We identified a total of 12 cases, including 4 cases of gliptin-induced bullous pemphigoid, 2 of vesiculodermatitis, 1 of acute generalized exanthematous pustulosis (AGEP), and 5 of cutaneous vasculitis. Clinical evaluations revealed distinctive morphological characteristics, leading to appropriate investigations to confirm the diagnoses. Naranjo scoring established a “probable causality” with gliptin usage in the majority of these cases.
Discussion: Our findings suggest a potential correlation between gliptin use and the development of diverse cutaneous dermatoses. Most conditions demonstrated a good prognosis upon discontinuation of the drug, except in 4 cases of bullous pemphigoid and 2 of the 5 cases of vasculitis. The resolution of symptoms in most patients following the discontinuation of gliptin and the initiation of appropriate dermatological therapy further strengthen this association
Conclusion: This case series contributes valuable insights into the varied dermatological manifestations potentially induced by gliptins, thereby informing improved patient management.
