Disorder | Clinical features | Diagnostic tests |
Dermatitis | Linear configuration if contact dermatitis. | H&E: spongiosis |
Bullous tinea pedis | Vesicles on soles of feet or between the toes. | KOH examination demonstrating hyphae or positive fungal culture |
Fixed drug eruption | Dusky violaceous patch, hemorrhagic bulla; may recur at same location with future drug exposures. |
History H&E: lichenoid or interface dermatitis |
Erythema multiforme | Targetoid papules on extremities and acral locations; hemorrhagic vesicles/bullae; intermittent recurrences usually associated with HSV infection. | H&E: vacuolar interface dermatitis; positive confirmation of concurrent HSV outbreak |
Friction blisters | Most commonly seen on soles of feet or palms of hands at sites of friction. |
History H&E: intraepidermal blister |
Coma blisters | Tense blisters at sites of pressure in comatose patients. |
History H&E: subepidermal blister and eccrine gland necrosis |
Bullous insect bites | Intense pruritus and erythematous papules. | History |
Bullous disease of diabetes (bullous diabeticorum) | Tense blisters found predominately on lower extremities. Lack of erythema or inflammation. Rare manifestation of diabetes. |
H&E: pauci-inflammatory subepidermal blister DIF: negative |
Grover's (transient acantholytic dermatosis) | Keratotic eroded papules and vesicles on the abdomen, chest, back. Male predominance. Often worsens with heat, exercise, hospitalization. |
H&E: dyskeratosis and acantholysis DIF: negative |
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