Diabetic Bullae

Diagnosis: Diabetic Bullae

Large, intact bullae, on noninflamed skin arise spontaneously in diabetic patient.

Clinical Presentation

Large, intact bullae, on noninflamed skin arise spontaneously in diabetic patient.

Clinical History

Submitted by Alaa Saad. Originally posted October 19, 2010.

Treatment

See case discussion.

Differential Diagnosis

• Bullous pemphigoid • Epidermolysis bullosa acquisita • Friction blister • Bullous drug eruption • Porphyria cutanea tarda • Edema blisters

Key Learnings

• Bullosis diabeticorum — spontaneous, painless, tense blisters on feet and lower legs • Exclusively in diabetic patients — pathognomonic for diabetes • No preceding trauma — blisters arise spontaneously • Self-limited — heal without scarring in 2-6 weeks • Clear, sterile fluid • Differential must exclude PCT (check porphyrins) and bullous pemphigoid (DIF)

Tags: diabetic, bullae, alaa saad