Trunk Blisters

Blisters on the trunk include those on the chest,back and abdomen.

On these areas blisters are usually due to Herpes Zoster(unilateral and painful) bullous staph infection,bullous pemphigoid,plant contact dermatitis and drugs causing toxic epidermal necrolysis.Pemphigus blisters are fragile and soon form crusts and erosions.Rarer immunobullous diseases such as dermatitis herpetiformis and linear IgA disease will cause blisters in these areas.Fixed drug eruption may cause localised blistering.

Management   Culture for bacteria and viruses,do a Tzanck smear,do a gram stain and biopsy and immunofluorescence if you consider an immunobullous disease is likely.

 

Herpes Zoster

Bullous pemphigoid

Plant contact

 

 

SIGN DIP MEN Overview of Blisters

 

S-Squamous    Bullous Dariers disease, Acute eczema, Bullous pompholyx

 

 

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, Bullous mastocytosis, 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, Bullous scabies, 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, Bullous ichthyosiform erythroderma

Hemorrhagic Blisters  pemphigus, herpes zoster, leukemia, lichen sclerosus

Erosions   Pemphigus, Hailey Hailey, Eczema herpeticum

Sheets of skin   Staph scalded skin syndrome, Toxic epidermal necrolysis, Collodion baby