Skin blisters and broken skin are actually "pemphigoid" attacks! Doctor: Be careful when taking 1 diabetes medicine
Itching, rash and blisters? Beware of Pemphigoid Outbreak
Itching, red rashes, and even broken blisters of different sizes may appear on the skin. Don’t think it’s just a temporary allergy. It may be an attack of “pemphigoid”. Severe cases may even require hospitalization. Are there risks of infection and death? Since pemphigoid is more likely to occur in the elderly, in addition to requiring special attention in medication and care, many patients also have diabetes. Certain blood sugar medications may increase the risk of pemphigoid. You should see a doctor in time to evaluate whether adjustments are needed. drug.
Taipei Veterans General Hospital once admitted a 69-year-old man who suffered from a major attack of pemphigoid. During his hospitalization, in addition to oral steroids, he also used a variety of immunosuppressive drugs to reduce blisters and continued to care for large-scale broken skin wounds. Since the patient has diabetes and is taking dipeptidyl peptidase-inhibitor (DPP4 inhibitor) anti-diabetic medication, in order to reduce the risk of pemphigoid, the medication was changed after discussion with a metabolic doctor. The condition is currently under stable control, oral steroids have been reduced to the lowest dose, and only follow-up visits are required every three months.
The number of pemphigoid cases has tripled in ten years and is related to multiple chronic diseases
Director Wu Zhenyi of the Photochemical Therapy Department of the Department of Dermatology at Taipei Veterans General Hospital pointed out that pemphigoid is the most common autoimmune blistering disease among the elderly. It will cause symptoms such as skin itching, blisters, and broken skin, and requires long-term treatment with oral steroids or immunosuppressive drugs. , in severe cases, frequent hospitalization is required for medication and wound care, and poor control may even lead to serious infection or death.
Director Wu Zhenyi said that pemphigoid is when autoantibodies attack the skin, causing blisters. It often occurs in bedridden elderly people with multiple chronic diseases, or patients with neurological diseases such as dementia, stroke, and Parkinson’s disease. The incidence rate increases with age. There are about 1,000 new cases in Taiwan every year. As the population ages, the number of cases has more than tripled in the past decade.
Director Wu Zhenyi pointed out that the risk factors that may increase the risk of pemphigoid are mostly long-term inflammatory diseases, such as atopic dermatitis, psoriasis, and kidney dialysis. Studies have confirmed that they will increase the risk of pemphigoid. In addition, the latest published literature also proves that neurogenic tumors increase the occurrence of pemphigoid.
For pemphigoid, please note that diabetes medication SGLT2 is safer than DPP4
“Diabetes is a common comorbidity in pemphigoid patients, so you need to be particularly careful when using medication!” Director Wu Zhenyi said, Taipei Veterans General Hospital’s research found that dipeptidyl peptidase-inhibitor (DPP4 inhibitor) in type 2 diabetes medication Diabetic patients will more than double the risk of pemphigoid. In comparison, sodium-glucose transporter inhibitor type 2 (SGLT2 inhibitor) does not increase the risk of pemphigoid and is the safest drug for diabetes. choose.
“In addition, Taipei Veterans General Hospital found that patients with pemphigoid have an increased risk of venous thrombosis, and the oral steroids used in treatment are related to the probability of infection. Combined with immunosuppressive drugs, the mortality rate of pemphigoid patients can be reduced! "
Director Wu Zhenyi pointed out that the dosage of oral steroids is positively correlated with the infection rate. That is, the more oral steroids are used, the higher the chance of infection. Therefore, it is hoped that the dosage of oral steroids can be reduced as soon as possible while the blisters are under control.
Further reading:
