Diabetic bullae bhutani british journal of diabetes. Bullous disease of diabetes tends to arise in longstanding diabetes or in conjunction with multiple complications. Bullae located in the epidermis are flaccid and rupture easily. He was also found to have extensive induration of the skin over his back. Bullosis diabeticorum bullous disease of diabetes or diabetic bullae is a noninflammatory, blistering disease occurring spontaneously in diabetic patients. The massive bulla spontaneously ruptured and healed without com plication. Welldemarcated yelloworange plaques on the bilateralshins of a young female diabetic patient.
The blisters are usually large and asymmetrical in shape. We present a case of an obese male with poorly controlled diabetes who came to the hospital with upper back pain and subsequently developed sepsis due to a small deepseated abscess in his back that was drained and treated with antibiotics. Histology of a lesion demonstrated a bulla at the dermoepidermal junction, and ultrastructural studies. What you should be alert for in the history rapid and spontaneous development of one to several blisters, typically on the feet or lower extremities, without identifiable history of antecedent trauma. Note that this may not provide an exact translation in all languages. Diabetic bullae, also known as bullosis diabeticorum, are blisterlike lesions that occur spontaneously on the feet and hands of diabetic patients. Idiopathic bullae in diabetics bullosis diabeticorum. An unusual but characteristic bullous dermatosis occurring in diabetics, is described. The bullae arise on a noninflamed base and are clear and tense. Bullous definition of bullous by the free dictionary. Classic bullous pemphigoid presents with tense, serous, or hemorrhagic bullae of 1 to 3 cm in diameter on the trunk and extremities that are often associated with urticarial plaques. Skin disorders commonly occur in patients with diabetes and can affect approximately 30% of all diabetics.
Lesions are usually asymptomic and are most commonly located on the feet and lower legs. The pathophysiology of this condition remains unknown. These rapidly developing bullous lesions mostly occur in patients with long standing diabetes and neuropathy. Bullous disease of diabetes bullosis diabeticorum is a distinct, spontaneous, noninflammatory, blistering condition of acral skin that is unique to patients with diabetes mellitus. Although rare, diabetic bullae are a distinct marker for diabetes.
What is bullous disease of diabetes bullosis diabeticorum. Bullosis diabeticorum bd, also known as diabetic bullae or bullous. A rare blistering manifestation of diabetes find, read and cite all the research you need on researchgate. We present this case to illustrate the rare occurrence of diabetic bulla in a diabetic patient especially with poor glycemic control.
The bullae are usually located on acral skin surfaces, particularly the feet. They are prevalent between the ages of 17 and 84 years. Authoritative facts about the skin from dermnet new zealand. Partialthickness skull wounds treated without free tissue transfer in an outpatient setting. It is a spontaneous, non inflammatory, blistering condition usually found in longstanding diabetic patients with poor glycemic control. Bullae definition of bullae by the free dictionary. The pathophysiology of bullous disease of diabetes bullosis diabeticorum is likely multifactorial. Diabetic bullae, also known as bullosis diabeticorum, is a spontaneous, distinct, noninflammatory, blistering condition of the skin predominantly seen in patients with diabetes mellitus with a distadistribution. It is also termed as bullous disease of diabetes and diabetic. Media in category ancient roman bullae pendants the following 22 files are in this category, out of 22 total. Bullae article about bullae by the free dictionary. Diabetic bullae, also known as bullosis diabeticorum, is a spon taneous, distinct, noninflammatory, blistering condition of the skin predominantly seen in patients.
Porphyria cutanea tarda, bullous pemphigoid, epidermolysis bullosa, and pseudoporphyria are other differential diagnoses of bullous lesions. The distribution and appearance of the bulla led to a clinical diagnosis of bullosis diabeticorum, a rare but likely underdiagnosed condition in patients with diabetes. Tense bullae and pruritus photo quiz american family. Bullosis diabeticorum, also known as bullous disease of diabetes and diabetic bullae, is a rare, distinct, spontaneous, noninflammatory, blistering condition of. A distinctive blistering eruption in diabetes mellitus find, read and cite all the research you need on researchgate. A diabetic bulla is a cutaneous condition characterized by a noninflammatory, spontaneous, painless blister, often in acral locations peripheral body parts, such as feet, toes, hands, fingers, ears or nose, seen in diabetic patients. These serous fluid filled tense bullae sized few mm to cm may even sometimes be hemorrhagic. Bullous diabeticorum is a rare cutaneous, spontaneous, blistering condition affecting approximately 0. Rocca and pereyra first characterized this as a phlyctenar appearing like a burninduc. Bullosis diabeticorum, journal of general internal. The bullae occur more frequently in adult men with long standing diabetes and neuropathy.
Bullous diabeticorum, diabetes, hemorrhagic bullae introduction bullous diabeticorum bd is a noninflammatory blistering disease occurring spontaneously in diabetic patients wilson et al. He suffered from intermittent formation of diabetic bullae on 50 occasions during an. Bullosis definition of bullosis by medical dictionary. These painless bullae may be the first presentation of diabetes, appearing suddenly, commonly on lower limbs. Pdf on jan 1, 2009, sudip kumar ghosh and others published bullosis diabeticorum. We report a case of bullosis diabeticorum with blisters confined to the lower legs and feet.
What is the pathophysiology of bullous disease of diabetes. A rare, confusing and controversial entity reportedly affecting 0. These conditions include bacterial infections such as furunculosis, cellulitis, and folliculitis, and fungal. The diagnostic features which separate it from other bullous disorders ar. Bullosis diabeticorum bd or diabetic bulla is a spontaneous,recurrent,noninflammatory,andblisteringcondition usually affecting acral and distal skin of lower extremities. It can mimic other vesicobullous disorders, and is often underdiagnosed.
Bullosis diabeticorum is an infrequent but significant complication of diabetes mellitus most commonly affecting the hands and feet. Friction blisters occur below the corneal layer, but present as tense bullae due to the thick stratum corneum of volar skin. To access free multiple choice questions on this topic, click here. The nikolsky sign may be demonstrated in a patient with intraepithelial bullae by the shearing off of the epithelium with lateral pressure on intact skin. While this disease is unique to patients with diabetes, it may mimic other blistering disorders. Bullous diabeticorum is a rare cutaneous complication of diabetes mellitus dm. Bullosis diabeticorum postgraduate medical journal. Bullosis diabeticorum lesions heal spontaneously within 26 weeks and often recur in the same or different acral locations. Bullous diseases multiple bullae, confined to the lower extremities may ocur in diabetic patients it is called bullosis diabeticorum 7. Bullosis diabeticorum is a rare condition with about 100 cases described in the literature. Skin problems associated with diabetes mellitus dermnet nz. Utrecht, the netherlands the case of a male diabetic patent with recurrent bullous lesions restricted to the hands is reported. Scleredema diabeticorum is a rare cutaneous manifestation of diabetes mellitus. The bullae were treated with hydrotherapy and healed with no complications in 4 weeks.
Eb simplex where cleavage is intraepidermal, it appears at birth with bullae formation limited to. Bullosis diabeticorum is also known as bullous disease of diabetes and is a rare, distinct, spontaneous, noninflammatory blister forming condition where the aetiology is not quite known. Bullosis diabeticorum bd or diabetic bulla is a spontaneous, recurrent, noninflammatory, and blistering condition usually affecting acral and distal skin of lower extremities. Pdf on jul 1, 2017, debajyoti chatterjee and others published bullous diabeticorum. Dermnet nz random random translate translate close search. Tell a friend about us, add a link to this page, or visit the webmasters page for free fun content. In 1930, kramer first reported bullous like lesions in diabetic patients. Idiopathic bullae in diabetics bullosis diabeticorum idiopathic bullae in diabetics bullosis diabeticorum bear, colin l wall, leon m.
Kramer first reported bullous like lesions in diabetic patients in 1930. Scleredema diabeticorum with superimposed cellulitis and. Investigations which included skin biopsies confirmed the diagnosis of bullosis diabeticorum. Since the bullae had a nonerythematous base and were of acral distribution, bullosis diabeticorum was diagnosed.
The children that are affected by epidermolysis bullosa are called butterfly or cotton wool babies because their skin is fragile. Bullae typically rupture after being present for approximately one week and leave deep, painless. The diagnostic features which separate it from other bullous disorders are discussed, and a possible etiologic mechanism is suggested. A giant bulla is a large pocket of air occupying at least one third of the hemithorax. Bullosis diabeticorum bullous disease of diabetes or diabetic bullae is a.
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