Teneligliptin-associated bullous pemphigoid in an elderly man with diabetes

Dermatology consultation was sought by a 69-year-old man for complaints of recent-onset erythematous, itchy, fluid-filled lesions that appeared either spontaneously or were incited by minor trauma and tended to rupture within 4–5 days. On examination, there were few (<10 in number) haemorrhagic blisters of variable sizes (maximum up to 2 cm diameter) distributed on the chest, abdomen and upper extremities (figure 1A and B). The bullae had settled down or eroded and had healed with hypopigmentation at few places. No mucosal involvement was seen. His nails were normal. Figure 1 (A,B) Few, scattered haemorrhagic bullae, distributed on the neck, chest, abdomen and upper extremities. Some of the bullae had ruptured and healed, leaving behind hypopigmentation, while many had settled as such. Note the characteristic absence of background urticarial and eczematous lesions, and relatively small-sized bullae. (C,D) Split at the dermoepidermal junction with blister cavity containing eosinophils and neutrophils. The dermis shows moderate inflammatory infiltrate comprising eosinophils and lymphomononuclear …