A Case Report of Dapagliflozin-Induced Nodular Vasculitis

Abstract

Introduction Nodular vasculitis (NV) was first mentioned by Montgomery in 1945 for erythema induratum-like lesions (1). NV is a rare form of panniculitis and is usually localized on the calves. Characterized by plaques and erythematous nodules, NV may occasionally show ulceration and draining. It is considered a reactive disease associated with many causative factors (2). Some of the infectious causereported in previous studies for NV are Tuberculosis, Nocardia, Fusarium, Pseudomonas, Chlamydia, and hepatitis C virus (3-5). Some cases of NV have also been found associated with non-infectious conditions such as drugs (6,7), inflammatory bowel diseases (8), several autoimmune diseases (9), and rare malignant diseases (10,11). Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are oral antidiabetic drugs that inNodular vasculitis (NV), first described by Montgomery in 1945 for erythema induratum-like lesions, is a rare form of panniculitis that is particularly localized on the calves. Characterized by plaques and erythematous nodules, NV may often show ulceration and draining. It is known as a reactive disease associated with many causative factors. Several NV cases due to infectious or non-infectious causative factors have been reported, but no case of NV due to sodium-glucose cotransporter-2 inhibitors (SGLT2i) has yet been reported. In this case report, we presented a case diagnosed with NV, who presented with tender, erythematous, eroded plaques with hemorrhagic-purulent discharge on both legs during treatment with dapagliflozin (an SGLT2i).