Clinical Approach to Diffuse Blisters

Jaleel, Tarannum; Kwak, Young Ho; Sami, Naveed

doi:10.1016/j.mcna.2015.07.009

Cited by 4 publications

(4 citation statements)

References 22 publications

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“…Some blistering eruptions are self-limited but others are life-threatening which requires prompt diagnosis and management. 6 Infections and drug eruptions constituted the most common diagnosis in skin ward which was the same in our study too. 5 Our study showed that almost two third (63%) were nonimmunobullous in nature and only 37% of the total cases were autoimmune among the admitted cases.…”

Section: Discussionsupporting

confidence: 72%

Blistering Diseases in a Tertiary Care Hospital: A 10-year Audit

Parajuli

Lama

Karki

et al. 2020

Nepal J Dermatol Venereol & Leprol

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Introduction: Cutaneous blisters can occur in variety of conditions. They are broadly classified as immunobullous or non-immunobullous. Immunobullous blistering diseases can further classify as intraepidermal or subepidermal. Non-immunobullous blistering disease are commonly due to infections, drugs among others. Some of the blistering disease carry significant mortality and morbidity. There are only limited data on blistering diseases from Nepal, so this study will provide details on the prevalence of this rare dermatological disease from one of the tertiary care referral hospital in the country. Objective: To assess the clinical pattern and prevalence of various blistering diseases in a tertiary care referral hospital. Materials and Methods: All of the data were obtained from the admission register maintained at department of dermatology and venereology, National Academy of Medical Sciences. All the patients admitted with blistering disease from year April 2008 till March 2018 were included. The details including age, sex, type of blistering disease and length of hospital stay were recorded. Results: A total of 710 patients were admitted in the dermatology ward over the period of 10 years. There were a total of 193 blistering disease admitted during this period. Autoimmune blistering disease was diagnosed in 59 patients whereas 100 patients had non-immunobullous disease. The age grouped range from 4- 93 years with the mean age of 43± 19.71 years. The average number of hospital stay of all blistering diseases was 11.73±11.36 days. Conclusion: Blistering diseases are one of the most common conditions requiring admission in dermatology ward. Some of these diseases carry a significant morbidity and mortality. So, prompt diagnosis and treatment is of utmost importance.

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Section: Discussionsupporting

confidence: 72%

Blistering Diseases in a Tertiary Care Hospital: A 10-year Audit

Parajuli

Lama

Karki

et al. 2020

Nepal J Dermatol Venereol & Leprol

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“…1 Factors that help to differentiate such aetiologies include the distribution of lesions, involvement of mucous membranes and whether blisters are flaccid, tense or present as erosions (Table 1). 2 Histopathological factors including the level of blister formation (intraepidermal or subepidermal), mechanism of blister formation (spongiosis, acantholysis, blistering degeneration or epidermolysis) and the type of inflammation (neutrophilic, lymphocytic, eosinophilic, mixed) can guide diagnosis. 3 Direct immunofluorescence (DIF) of intact perilesional skin is also needed.…”

Section: Questionmentioning

confidence: 99%

Epidermolysis bullosa acquisita mechanica

Fordham¹,

Bricknell²,

Huang³

et al. 2023

Aust J Gen Pract

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“…When the skin is selectively affected, differential diagnosis includes contact dermatitis, adverse drug reactions, infections, systemic diseases, and autoimmune conditions. 1 Blistering diseases are generally associated with an immunity dysregulation causing the development of serum autoantibodies directed against cell-cell adhesion proteins within the epithelium or cell-matrix adhesion proteins of the basal membrane. 2,3 The localization of the vesicles and the bullae may therefore vary depending on the target of the autoimmunity, causing intraepithelial or subepithelial bullous lesions.…”

Section: Introductionmentioning

confidence: 99%

Ultra‐high frequency ultrasound in the differential diagnosis of oral pemphigus and pemphigoid: An explorative study

Izzetti

Nisi

Aringhieri

et al. 2021

Skin Research and Technology

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Objectives: Intraoral ultra-high frequency ultrasound (UHFUS) is an emerging technique in oral medicine, due to its possibility to provide submillimeter resolution imaging of superficial mucosal structures. In this study, the potential role of UHFUS in the diagnosis of oral pemphigus vulgaris (PV) and mucous membrane pemphigoid (MMP) is assessed. Materials and Methods: Consecutive patients with suspected oral PV or MMP were enrolled. All patients underwent clinical examination, laboratory tests, intraoral UHFUS scan, and biopsy. Histology and direct immunofluorescence were set as benchmark for diagnosis confirmation. The sensitivity and specificity of UHFUS compared to histology were assessed. Mann-Whitney test was performed to evaluate the presence of differences in the echogenicity of PV and MMP. P-value was set at P < 0.05.Results: Twenty-five patients were included. Thirteen patients were diagnosed with PV, and twelve with MMP. The UHFUS features of PV and MMP lesions were described. Image analysis showed statistically significant differences between the echogenicity of PV and MMP lesions (P < 0.05). Good concordance between UHFUS and histology was found. UHFUS showed 75% sensitivity in the diagnosis of PV and 66.7% in the diagnosis of MMP.Conclusions: UHFUS appears a valuable tool in the diagnosis of PV and MMP.Although histology and immunofluorescence remain the gold standard, UHFUS role in the diagnostic algorithm of PV and MMP seems promising as a chair-side tool consistently enhancing clinical evaluation of oral bullous lesions.

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Clinical Approach to Diffuse Blisters

Cited by 4 publications

References 22 publications

Blistering Diseases in a Tertiary Care Hospital: A 10-year Audit

Blistering Diseases in a Tertiary Care Hospital: A 10-year Audit

Epidermolysis bullosa acquisita mechanica

Ultra‐high frequency ultrasound in the differential diagnosis of oral pemphigus and pemphigoid: An explorative study

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