{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T18:29:09Z","timestamp":1778178549507,"version":"3.51.4"},"reference-count":12,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,2,11]],"date-time":"2021-02-11T00:00:00Z","timestamp":1613001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,2,11]],"date-time":"2021-02-11T00:00:00Z","timestamp":1613001600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Endocr Disord"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Bullous pemphigoid is the most common bullous chronic autoimmune skin disease. Recent studies have suggested dipeptidyl-peptidase 4 inhibitors as possible predisposing agents of bullous pemphigoid. The objective of our study was to prospectively estimate the association between gliptins and the development of bullous pemphigoid.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We conducted a prospective study which included all patients diagnosed with biopsy-proven bullous pemphigoid in the Dermatology Department of our hospital between April 1, 2009 and December 31,2019. The diagnosis of bullous pemphigoid was based on specific clinical, histological and immunological features.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Overall 113 consecutive patients (age 75\u2009\u00b1\u200913\u2009years, 62 females) with the diagnosis of bullous pemphigoid were enrolled. Seventy-six patients (67.3%) suffered from type 2 Diabetes and 52 (46%) were treated with dipeptidyl-peptidase 4 inhibitors. The most frequent prescribed gliptin was vildagliptin, being administered to 45 cases (39.8% of total patients enrolled, 86.5% of the patients treated with gliptins). Gliptins were withdrawn immediately after the diagnosis of bullous pemphigoid, which together with steroid administration led to remission of the rash.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>This study revealed that treatment with dipeptidyl-peptidase 4 inhibitors, especially vildagliptin, is significantly associated with an increased risk of bullous pemphigoid development.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12902-021-00689-7","type":"journal-article","created":{"date-parts":[[2021,2,11]],"date-time":"2021-02-11T17:04:01Z","timestamp":1613063041000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["The association of bullous pemphigoid with dipeptidyl-peptidase 4 inhibitors: a ten-year prospective observational study"],"prefix":"10.1186","volume":"21","author":[{"given":"Vaia","family":"Lambadiari","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aikaterini","family":"Kountouri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Foteini","family":"Kousathana","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanouil","family":"Korakas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgios","family":"Kokkalis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sofia","family":"Theotokoglou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lina","family":"Palaiodimou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pelagia","family":"Katsimbri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ignatios","family":"Ikonomidis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantinos","family":"Theodoropoulos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evangelia","family":"Papadavid","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,2,11]]},"reference":[{"key":"689_CR1","doi-asserted-by":"publisher","first-page":"1506","DOI":"10.3389\/fimmu.2019.01506","volume":"10","author":"G Genovese","year":"2019","unstructured":"Genovese G, Di Zenzo G, Cozzani E, Berti E, Gugno M, Marzano A. New insights into the pathogenesis of bullous Pemphigoid: 2019 update. Front Immunol. 2019;10:1506.","journal-title":"Front Immunol"},{"issue":"10","key":"689_CR2","doi-asserted-by":"publisher","first-page":"1152","DOI":"10.1001\/jamadermatol.2018.2352","volume":"154","author":"K Kridin","year":"2018","unstructured":"Kridin K, Bergman R. Association of Bullous Pemphigoid with Dipeptidyl-peptidase 4 inhibitors in patients with diabetes estimating the risk of the new agents and characterizing the patients. Jama Dermatol. 2018;154(10):1152\u20138.","journal-title":"Jama Dermatol"},{"issue":"6","key":"689_CR3","doi-asserted-by":"publisher","first-page":"1090","DOI":"10.1016\/j.jaad.2017.12.038","volume":"78","author":"M Benzaquen","year":"2018","unstructured":"Benzaquen M, Borradori L, Berbis P, Cazzaniga S, Valero R, Richard M, et al. Dipeptidyl peptidase IV inhibitors, a risk factor for bullous pemphigoid: retrospective multicenter case-control study from France and Switzerland. J Am Acad Dermatol. 2018;78(6):1090\u20136.","journal-title":"J Am Acad Dermatol"},{"key":"689_CR4","doi-asserted-by":"publisher","unstructured":"Masmoudi W, Vaillant M, Vassileva S, Patsatsi A, Quereux G, Moltrasio C, et al. Auto immune bullous skin disease task force of the EADV. International validation of the bullous Pemphigoid disease area index (BPDAI) severity score and calculation of cut-off values for defining mild, moderate and severe type of bullous pemphigoid. Br J Dermatol. 2020. https:\/\/doi.org\/10.1111\/bjd.19611.","DOI":"10.1111\/bjd.19611"},{"issue":"2","key":"689_CR5","doi-asserted-by":"publisher","first-page":"1120","DOI":"10.4049\/jimmunol.181.2.1120","volume":"181","author":"U Forssmann","year":"2008","unstructured":"Forssmann U, Stoetzer C, Stephan M, Kruschinski C, Skripuletz T, Schade J, et al. Inhibition of CD26\/dipeptidyl peptidase IV enhances CCL11\/eotaxin-mediated recruitment of eosinophils in vivo. J Immunol. 2008;181(2):1120\u20137.","journal-title":"J Immunol"},{"key":"689_CR6","doi-asserted-by":"publisher","first-page":"1610","DOI":"10.2741\/2785","volume":"13","author":"M Gonzalez-Gronow","year":"2008","unstructured":"Gonzalez-Gronow M, Kaczowka S, Gawdi G, Pizzo SV. Dipeptidyl peptidase IV (DPP IV\/CD26) is a cell-surface plasminogen receptor. Front Biosci. 2008;13:1610\u20138.","journal-title":"Front Biosci"},{"key":"689_CR7","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1016\/j.vascn.2014.11.002","volume":"71","author":"Y Huan","year":"2015","unstructured":"Huan Y, Jiang Q, Liu JL, Shen ZF. Establishment of a dipeptidyl peptidases (DPP) 8\/9 expressing cell model for evaluating the selectivity of DPP4 inhibitors. J Pharmacol Toxicol Methods. 2015;71:8\u201312.","journal-title":"J Pharmacol Toxicol Methods"},{"issue":"3","key":"689_CR8","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1111\/1346-8138.15195","volume":"47","author":"CT Hung","year":"2020","unstructured":"Hung CT, Liu JS, Cheng CY, et al. Increased risk of bullous pemphigoid in dipeptidyl peptidase 4 inhibitors: a nationwide, population-based, cohort study in Taiwan. J Dermatol. 2020;47(3):245\u201350. https:\/\/doi.org\/10.1111\/1346-8138.15195.","journal-title":"J Dermatol"},{"key":"689_CR9","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1111\/jcpt.12397","volume":"41","author":"M Garc\u00eda","year":"2016","unstructured":"Garc\u00eda M, Aranburu MA, Palacios-Zabalza I, Lertxundi U, Aguirre C. Dipeptidyl peptidase-IV inhibitors induced bullous pemphigoid: a case report and analysis of cases reported in the European pharmacovigilance database. J Clin Pharm Therapeut. 2016;41:368\u201370. https:\/\/doi.org\/10.1111\/jcpt.12397.","journal-title":"J Clin Pharm Therapeut"},{"issue":"2","key":"689_CR10","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1001\/jamadermatol.2018.4556","volume":"155","author":"SG Lee","year":"2019","unstructured":"Lee SG, Lee HJ, Yoon MS, Kim DH. Association of Dipeptidyl Peptidase 4 inhibitor use with risk of bullous Pemphigoid in patients with diabetes. JAMA Dermatol. 2019;155(2):172\u20137.","journal-title":"JAMA Dermatol"},{"issue":"2","key":"689_CR11","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1111\/j.1468-3083.2011.04062.x","volume":"26","author":"K Skandalis","year":"2012","unstructured":"Skandalis K, Spirova M, Gaitanis G, Tsartsarakis A, Bassukas ID. Drug-induced bullous pemphigoid in diabetes mellitus patients receiving dipeptidyl peptidase-IV inhibitors plus metformin. J Eur Acad Dermatol Venereol. 2012;26(2):249\u201353.","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"689_CR12","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2020.1587","volume":"1","author":"SD Liu","year":"2020","unstructured":"Liu SD, Chen WT, Chi CC. Association between medication use and bullous Pemphigoid: a systematic review and meta-analysis [published online ahead of print, 2020 Jun 17]. JAMA Dermatol. 2020;1:e201587. https:\/\/doi.org\/10.1001\/jamadermatol.2020.1587.","journal-title":"JAMA Dermatol"}],"container-title":["BMC Endocrine Disorders"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12902-021-00689-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12902-021-00689-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12902-021-00689-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,11]],"date-time":"2021-02-11T17:06:30Z","timestamp":1613063190000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcendocrdisord.biomedcentral.com\/articles\/10.1186\/s12902-021-00689-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,11]]},"references-count":12,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["689"],"URL":"https:\/\/doi.org\/10.1186\/s12902-021-00689-7","relation":{},"ISSN":["1472-6823"],"issn-type":[{"value":"1472-6823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,11]]},"assertion":[{"value":"10 November 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 February 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 February 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The study was approved by Ethics Commitee of General University Hospital Attikon. An informed consent statement was obtained from all the participants.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"23"}}