Vesicular and bullous lesions
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Vesicular and bullous lesions | |
Skin: Dyshidrosis, Vesicular; Vesiculobullous Diseases |
Template:Search infobox Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
To avoid missing serious causes, Vesicular and Bullous lesions must be approached systemically.
Primarily, the decision as to whether lesions are focal or diffuse is made, lesion history is taken, system review, and a focused physical exam. Non obvious lesions should be referred to a dermatologist.
Differential Diagnosis
In alphabetical order. [1] [2]
Localized
- Allergic contact Dermatitis
- Bullous impetigo
- Bites from various insects
- Burns
- Diabetics
- may develop bollous on the legs
- Dyshidrotic eczema (pompholyx)
- Friction blisters
- Herpes Zoster
- Herpes Simplex Viruses
- Shingles
Diffuse
- Blistering diseases
- Polymorphous light eruption
- Stevens-Johnson Syndrome
- Toxic epidermal necrolysis (TEN)
- Varicella
Other
Skin biopsy if PCT, pemphigus, and pemphigoid is seen
Laboratory Findings
- Obtain HSV-2 culture if suspect.
Diagnostic Findings
-
Skin: Tinea Pedis, Vesicular; Vesiculobullous Diseases
-
Skin: Dyshidrosis, Vesicular; Vesiculobullous Diseases
-
Skin: Scabies, Vesicular; Vesiculobullous Diseases
-
Skin: Erythema Multiforme, Vesicular; Vesiculobullous Diseases
-
Skin: Erythema Multiforme, Vesicular; Vesiculobullous Diseases
-
Skin: Pityriasis Lichenoides, Vesicular; Vesiculobullous Diseases
Treatment
Acute Pharmacotherapies
HSV-1, HSV-2, HZV
Bullous impetigo
- topical mupirocin
- systemic antibiotics
Pemphigus
- Systemic immunosuppressants
Chronic Pharmacotherapies
SJS/TEN
- discontiue offending drug
- IVIG
- Systemic steroids
Dyshidrotic eczema
- high potency topical steroid
- heavy emollients
References
Acknowledgements
The content on this page was first contributed by Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]
List of contributors: