D. Tsambaos

Bullous pemphigoid (BP) is an autoimmune disorder characterized by the production of autoantibodies against two antigens (BPAG1 and 2) and can be induced by drugs (1,2). Recently, the development of BP was reported in diabetic patients treated with dipeptidyl peptidase-4 inhibitors (gliptins) plus metformin (3). However, it remains unknown whether gliptins alone or in combination with metformin are responsible for the induction of BP. We report two diabetic patients who developed BP shortly after addition of vildagliptin to their metformin monotherapy. A 59-year-old woman and a 67-year- old man, both with type 2 diabetes that had been controlled with metformin for 6 and 3 years, respectively, presented with an 1- and 3-month history of pruritic …

The effects of the aromatic retinoid RO 10-9359 on the fine structure of psoriatic dermis were investigated by electron microscopy in five patients after 1, 2, and 3 weeks of treatment (I mg/kg/day). Our findings show that aromatic retinoid, additionally to its epidermal effects, exerts a distinct influence on dermal components in psoriasis. Ultrastructural evidence is provided suggesting that this drug stimulates lymphocytes and monocytes, promoting their differentiation into Sézary-like lymphocytic cells, activated macrophages and dermal Langerhans cells. The appearance of these immunocompetent cell lines may modulate the cell-mediated immune response in psoriasis, obviously reflecting a pharmacological action of the drug additional to its definite influence on epidermal keratinization.