Bullous Pemphigoid Induced by Cefixime: A Rare Side Effect

Bullous pemphigoid (BP) is the most prevalent autoimmune subepidermal blistering disease of the skin and mucous membranes. This disease typically affects the elderly and manifests with pruritus and localized or, most commonly, generalized bullous lesions. Numerous studies have established the association between BP and oral antidiabetic agents, particularly dipeptidyl peptidase 4 (DPP4) inhibitors, diuretics, and certain antibiotics, notably levofloxacin and cephalexin. In this report, we present a case of an 85-year-old female who presented with diffuse vesicles and bullae on her trunk and extremities five days after completing a four-week course of cefixime for pyelonephritis. Clinical examination and histopathological analysis confirmed the diagnosis of BP. The patient responded well to topical and systemic corticosteroids. This article presents the first documented case of BP induced by cefixime and underscores the importance of considering medication-induced BP in elderly patients presenting with blistering eruptions.