Gliflozin (SGLT2 inhibitor) induced vulvitis

Area of Science:

• Dermatology
• Endocrinology
• Pharmacology

Background:

• Sodium-glucose co-transporter 2 (SGLT2) inhibitors are widely used for diabetes management.
• Genital infections, particularly candidiasis, are common adverse effects due to induced glycosuria.
• Cutaneous manifestations of SGLT2 inhibitor-associated vulval symptoms are not well-documented.

Purpose of the Study:

• To describe the specific inflammatory vulvitis with psoriasiform features observed in patients using SGLT2 inhibitors.
• To investigate the association between SGLT2 inhibitor therapy and vulval candidiasis.
• To evaluate treatment outcomes for SGLT2 inhibitor-induced vulvitis.

Main Methods:

• Retrospective analysis of 11 patients experiencing inflammatory vulval changes after initiating SGLT2 inhibitors.
• Review of demographic data and treatment outcomes from electronic medical records.
• Clinical observation of characteristic inflammatory vulvitis with psoriasiform features.

Main Results:

• Ninety-one percent (10/11) of patients had concurrent candidiasis, successfully treated with fluconazole.
• Topical treatments allowed 54.5% (6/11) of patients to continue SGLT2 inhibitor therapy.
• Five patients (45.5%) required discontinuation of SGLT2 inhibitors due to persistent symptoms.

Conclusions:

• SGLT2 inhibitors can precipitate a distinct form of inflammatory vulvitis.
• Combined treatment with topical agents and oral antifungals may enable continued SGLT2 inhibitor use.
• Early recognition and treatment are crucial to manage symptoms and allow patients to benefit from SGLT2 inhibitors for glycemic control.