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Blistering skin conditions

Author: Dr Amanda Oakley, Dermatologist, Hamilton, New Zealand, 1997. Updated September 2015.

What are blistering diseases?

Blistering diseases are conditions in which there are fluid-filled skin lesions.

Acute blistering diseases

Acute blistering diseases can be generalised or localised to one body site, and are due to infection or inflammatory disorders. Although most commonly eczematous, generalised acute blistering diseases can be life threatening and often necessitate hospitalisation.

 Acute blistering conditions should be investigated by taking swabs for bacterial and viral culture. Skin biopsy may be helpful in making a diagnosis.

Acute generalised blistering disease

Acute febrile neutrophilic dermatosis 

Atypical enterovirus infection 

Chickenpox/varicella 

Eczema herpeticum 

Dermatitis

Polymorphic light eruption 

Erythema multiforme 

Stevens Johnson syndrome / toxic epidermal necrolysis

Drug hypersensitivity syndrome 

Staphylococcal scalded skin syndrome 

Acute localised blistering disease     

Acute dermatitis

Bullous impetigo 

Chilblains 

Enteroviral vesicular stomatitis 

Clears in a few days       

Erysipelas 

Fixed drug eruption 

Herpes simplex

Herpes zoster (shingles) 

Insect bites and stings

Miliaria 

Necrotising fasciitis 

Transient acantholytic dermatosis 

Trauma

Chronic blistering diseases

Diagnosis of chronic blistering diseases often requires skin biopsy for histopathology and direct immunofluorescence. A blood test for specific antibodies (indirect immunofluorescence) may also prove helpful in making the diagnosis of an immunobullous disease.

Blistering genodermatoses

Epidermolysis bullosa 

Fogo selvagem

Mastocytosis 

Benign familial pemphigus 

Chronic acquired blistering

Bullous pemphigoid 

Dermatitis herpetiformis 

 Other immunobullous diseases

Porphyria cutanea tarda 

 

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