Face Blisters

 If there are Blisters or vesicles The mnemonic is ICI(Imperial Chemical Industries) Infective, Contact dermatitis and Inflammatory including Immunological .
Inflammatory causes can include drugs but remember Immunological causes in the elderly particularly bullous pemphigoid. Contact dermatitis usually gives smaller vesicles rather than blisters but individual vesicles can join up into blisters. If blisters are linear and itchy it is probably a Plant contact dermatitis. Infective blisters are usually bullous impetigo due to a staph infection. If in a dermatomal distribution blisters are likely to be Herpes Zoster.

Face and Blisters

The commonest causes are plant contact dermatitis,phototoxic drug reactions,herpes zoster and porphyria cutanea tarda and bullous staph infections.Blistering contact dermatitis from a hair dye is also a possibility.

 

Face and Purpura Purpura in the face is usually seen in conjunction with purpura elsewhere.  If purpura is confined around the eyes and eyelids, consider local trauma but also unusual conditions such as post whooping cough and due to primary systemic amyloidosis infiltrating the capillaries around the eyelids causing weakness and purpura. 

 

SIGN DIP MEN  Overview of Blisters

 

S-Squamous    Bullous Dariers disease,

 

I-Infective   Impetigo,Staph scalded skin syndrome,Herpes zoster,Bullous tinea,Parvovirus B19,Staph infected varicella,Bullous orf,Pseudomonas septicemia,Hemorrhagic bullae with Vibrio vulnificus,Mucor infection in immunosupressed,Blistering dactylitis

 

G-Granulomatous

 

N-Neoplastic  Paraneoplastic pemphigus,

 

D-Drugs   Toxic epidermal necrolysis,Fixed drug eruption,Numerous drugs causing the immunobullous disaeases,Pseudoporphyria,Barbiturate coma,

 

I-Immunological    Plant contact dermatitis,Phytophoto dermatitis,Erythema multiforme,Bullous pemphigoid,Pemphigus,Dermatitis herpetiformis,Linear igA disease,Chronic bullous dermatosis of childhood,Bullous lupus, Mucosal Pemphigoid,Epidermolysis bullosa aquisita,Herpes Gestationis,Lichen sclerosus ,Bullous morphea,Bullous necrotising vasculitis,

 

P-Physical   Friction blister,Burns, Insect bite reaction,Lymphedema,Puva blisters,Tanning bed Pseudoporphyria,Polymorphous light eruption,Edema blisters of the leg,Sucking blisters in neonates,Epidermolysis bullosa,

 

M-Metabolic    Porphyria cutanea tarda,Diabetes mellitus,Amyloidosis,Blisters of hemodialysis,Mastocytosis,

 

E-Endocrine   Hypothyroidism,

 

N-Nutritional    Pellagra,Acquired zinc deficiency,Acrodermatitis enteropathica,

 

Others   Pompholyx eczema palms and soles,Congenital syphilis,Kindler syndrome,Neonatal purpura fulminans,Incontinentia pigmenti,