Epitope spreading phenomena in dipeptidyl peptidase‐4 inhibitor‐associated bullous pemphigoid

Abstract

Dipeptidyl peptidase‐4 inhibitor‐associated bullous pemphigoid (DPP4i‐BP) has been linked to a characteristic non‐inflammatory BP phenotype and to the presence of autoantibodies directed against the midportion of BP180 ectodomain. However, DPP4i‐BP cases with clinical and immunological findings of classical inflammatory BP have also been reported.

In the September issue of the BJD, Mai et al reported three cases of DPP4i‐BP. Initially, all patients had a non‐inflammatory BP with negative anti‐BP180 NC16A autoantibodies but evolved to an inflammatory BP along with the appearance of positive antibodies against the BP180 NC16A.

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