A Localized Painful Rash Induced By Linagliptin In A Patient With Type 2 Diabetes

The number of patients with type 2 diabetes using dipeptidyl peptidase-4 (DPP-4) inhibitors is increasing across the world. Although this class of antidiabetic medications is generally safe and associated with less side effects compared to other oral antidiabetic medications, they could also cause some side effects such as skin rashes. Herein we report a case of type 2 diabetes patient who developed a painful maculopapular rash induced by linagliptin, a widely used DPP-4 inhibitor.A localized painful maculopapular rash developed on the palmar faces of the patient's hands almost 1 day after the initiation of the drug. The patient was using intensive insulin therapy before linagliptin was started. There was no eruption on the other body parts except the palmar faces of the hands. Following the discontinuation of the drug, the rash disappeared in about four days. The patient had no history of urticaria and did not use an ACE inhibitor. As far as we know, this is the first case report of a skin rash induced by linagliptin in the Turkish literature. This case report highlights a rare and lesser known side effect of linagliptin, a new member of DPP-4 inhibitors.