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