A Systematic Review of Drug-Induced Pemphigoid
Matthew J. Verheyden, Asli Bilgic, Dédée F. Murrell
Bullous pemphigoid is an autoimmune subepithelial disease characterised by pruritus followed by urticarial plaques and finally bullae on the skin and mucosa. Drug-associated bullous pemphigoid (DABP) is a term used to describe instances of bullous pemphigoid demonstrating clinical, histological, or immunopathological features identical or similar to those of the idiopathic form of bullous pemphigoid, associated with the systemic ingestion, or topical application of particular drugs. In this study, we conducted a comprehensive search of the literature according to PRISMA guidelines and a total of 170 publications were included in the final qualitative analysis. In conclusion, 89 drugs were implicated in DABP. The strongest evidence for DABP is seen with gliptins, PD-1/PD-L1 inhibitors, loop diuretics, penicillin and derivatives. An appreciation of the medications associated with bullous pemphigoid enables clinicians to identify potential cases of DABP earlier and cease the offending medication.
Our article provides a comprehensive review of the medications implicated in drug-associated bullous pemphigoid with detailed accounts of the associated pathomechanisms.
Having read this article, clinicians will be capable of suspecting and diagnosing drug-associated bullous pemphigoid, enabling prompt management to be implemented.