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Aims/Introduction  Bullous pemphigoid ( BP ) might be drug‐induced. The present study evaluated the relationship between  BP  and dipeptidyl peptidase‐4 inhibitors ( DPP 4Is).    Materials and Methods  We recruited patients diagnosed with  BP  at Ogaki Municipal Hospital from 1 December 2009 through 31 December 2017. We retrospectively collected data from medical records and divided patients into two groups based on whether they received  DPP 4Is. Additionally, we determined the incidence of  BP  in patients who were first prescribed  DPP 4Is at our hospital during the study period.    Results  Of 168 patients diagnosed with  BP , 133 (79.1%) were positive for anti‐ BP 180 NC 16a antibody. A total of 32 (19.0%) patients had been prescribed a  DPP 4I, 21 of whom (65.6%) were positive for anti‐ BP 180 NC 16a antibody; this rate was lower than that in patients not receiving a  DPP 4I (82.3%;  P  = 0.0360). A total of 16 patients with type 2 diabetes mellitus had not been prescribed a  DPP 4I; only one (6.3%) was positive for anti‐ BP 180 NC 16a antibody ( P  = 0.0339). During the study period, 9,304 patients were prescribed  DPP 4Is, eight of whom developed  BP ; six (75.0%) had non‐inflammatory  BP , and five of the six (83.3%) were negative for anti‐ BP 180 NC 16a antibody.    Conclusions  The positive rate of anti‐ BP 180 NC 16a antibody was lower in  BP  patients with  DPP 4I than without  DPP 4I, regardless of type 2 diabetes mellitus. The antibody titer was low in both the overall and type 2 diabetes mellitus populations. The prevalence of  BP  in 9,304 patients receiving  DPP 4Is was 0.0859%, which is higher than that in the general population. As  DPP 4Is are common diabetes treatments, we must be aware of the risk of  BP .

Dipeptidyl peptidase‐4 inhibitors‐associated bullous pemphigoid: A retrospective study of 168 pemphigoid and 9,304 diabetes mellitus patients