Bladder dermatosis: what is important to remember

Bubble (bullous) dermatoses – autoimmune response of the body, expressed in the formation of cavities on the skin with exudate – bubbles of various sizes. The name includes many common dermatological ailments (Dühring's dermatitis, pemphigus vulgaris) and rare pathologies (bullous pemphigoid). It is important to recognize vesicular dermatosis in a timely manner, to know the leading symptoms and not to provoke the onset of the disease, because treatment – guarantee of stable therapeutic remission or full recovery.

"Basic diagnostic procedures for blistering dermatoses"

When taking an anamnesis, the differential diagnosis of blistering dermatoses is based on 3 characteristics: the formation, duration and localization of the bubbles. The dermatologist should pay attention to the process of formation of exudative cavities, whether this period was accompanied by other symptoms (general malaise, neurological and / or somatic disorders, etc.). 

When evaluating the duration of the rashes, attention is paid to the fact that some pathologies (allergies, exudative erythema) are immediately manifested by the appearance of blisters. But rashes can be chronic and manifest:

• From the first days of life
• Periodic.

Sometimes, only by localization of cavities with exudate, a differential diagnosis is made and the correct diagnosis is established. For example, dyshidrotic eczema — itchy rashes that appear on the hands and feet. Experienced dermatologists are always interested in patients and the presence or absence of itching.

Severe itching is indicated by damaged blisters on exposed parts of the body that are accessible for scratching.

Instrumental methods for diagnosing blistering dermatosis include:

• Histological analysis
• Smear for cytological examination
• Immunofluorescent staining of tissue cells.

Laboratory blood tests for the presence of antibodies to desmosomes and / or antibodies to the basement membrane of the skin will be informative, therefore, tests are often prescribed by dermatologists to clarify the diagnosis. Patients do not undergo special preparation before biomaterial sampling.

Symptomatic presentation of various blistering dermatoses

Practically all cystic dermatoses are manifested from the oral mucosa and/or pharynx. The process then involves the epidermis of the trunk, upper and/or lower extremities. The clinic depends on the type of dermatoses. Below is an example of the symptoms of the most common types of disease – true,  vegetative, leaf-shaped, seborrheic pemphigus, dermatitis herpetiformis Duhring.

1. Table of symptoms for some types of dermatoses

N n/n	Diagnosis	Latin name of the disease	Symptomatic picture
1	Pemphigus vulgaris	pemphigus vulgaris	The blisters capture the palatine arches, pharynx, quickly open, leaving behind painful erosive cavities. After 30-32 days, they fall on the chest and back.
2	Pemphigus vegetans	pemphigus vegetans	Flabby blisters do not affect the oral cavity. They are located near the natural openings of the body and in the skin folds of the armpit, inguinal region, under the mammary gland in women
3	Pemphigus foliaceus	pemphigus foliaceus	At the beginning of the pathological process, the skin is slightly hyperemic, swelling is noticeable. Then a bubble appears, forming a sharply painful erosion after opening. After it dries, a layered crust forms. The disease spreads rapidly, accompanied by symptoms of intoxication
4	Pemphigus in the form of seborrhea	pemphigus erythematosus	Facial area and area of ​​hair growth on the head – these are limited areas of seborrheic lesions
5	Dühring's dermatitis herpetiformis	dermatitis herpetiformis Durhing	Against the background of erythema or apparently intact epidermis, tense vesicles, cavities with exudate, or   with hemorrhagic filling. The rash is symmetrical, localized on the extensor surfaces of the elbows, knees, buttocks, sacrum, shoulder blades and in the facial region

Causes of blistering dermatoses: in brief

The causes of various kinds of vesicular dermatoses are varied and largely depend on the type of diagnosis. For example, Duhring's dermatitis herpetiformis occurs with gluten intolerance, and pemphigus – with autoimmune processes, the appearance of antibodies to proteins and the destruction of intercellular bonds.

Bubble dermatoses – many-sided pathologies that require a dermatologist to carefully study the symptomatic picture. Only a careful study of the history of the disease, its symptoms and evaluation of diagnostic procedures will help to correctly differentiate the disease and make the correct diagnosis.

Blistering dermatoses can occur as a result of allergic reactions to medications, as a result of pollinosis (seasonal allergies) and ingestion of other allergens. Endocrine, immune, nervous system disorders and aggravated heredity – this is another list of reasons that trigger the mechanism for the development of the disease.

Read also: Chronic dermatoses of the scalp: how to distinguish and how to treat