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Bullae (with purulent fluid)

Introduction
Cause
Examine
Diagnosis

Introduction

Introduction The diameter of the blister is generally less than 1 cm, and those exceeding 1 cm are called bullae. Some scholars use 0.5cm as the boundary between blister and bullae. Blisters and bullae can be distributed in isolation, such as pemphigus; or they can be clustered in clusters, such as herpes zoster. The blister contains a serum, which is pale yellow. The blister contains blood and is red (called blood blister); the blister contains lymph fluid which is clear and transparent; the blister contains pus and is turbid. Serous vesicles can become pustules or blood blister. The shape of the blister can be semi-circular, conical, oblate or irregular, and some have a umbilical fossa in the center. The blister wall can be tense and light like a balloon; it can also be loose, like wrinkled paper. Blisters can occur on normal skin, or on inflammatory skin. There can be redness around the blisters, or nothing. The blister is contained in the skin and can be divided into blister under the corner layer due to the different depth of the site, such as white peony (also in the horn layer); blister and bullae in the epidermis, such as herpes simplex, chickenpox, pemphigus, etc. Under the epidermis bullae, such as bullous pemphigoid, polymorphic erythema. The blister can be a single chamber or a multi-chamber.

Cause

Cause

Genetic, elderly or low body resistance, pregnancy, drug allergies, etc. can cause bullous production.

Examine

an examination

Related inspection

Skin smear microscopy skin test skin color

There are bullae on the skin of the body, the blister wall is thin, the surface is slack, and it is easy to rupture. The possibility of pemphigus should be considered. To determine whether it is pemphigus, the blisters can be gently pushed by the hand. If the blisters can move under the skin, or the edges of the blisters expand, or the normal skin is shaken, erosion occurs, which is called Nissl's sign positive. If the blister Niezhen sign is positive, it can be initially diagnosed as pemphigus.

If the bullae appear in the whole body is caused by heredity, and there are many people in the family, and the bullae are marked with wrinkles, familial benign chronic pemphigus should be considered.

If the elderly or the body has low resistance, erythema appears on the skin, and bullae appear on the erythema or normal skin. The blister wall is thick and tense, and it is pushed, with obvious itching. Consider bullousness. The possibility of pemphigus.

If pregnant women have blisters, mainly in the limbs, the bullae will disappear after pregnancy. If the pregnancy is repeated, the bulls will reappear, and the possibility of pregnancy herpes should be highly suspected.

If it is caused by drug allergies, bullae appear in the body, should consider bullous polymorphic erythema, toxic epidermal necrolysis, bullous drug eruption, malignant bullous erythema and other diseases.

There are also some non-bullous diseases, such as erysipelas, papular urticaria, frostbite, etc. when there is a serious rash; there are some rare diseases, the rash can be manifested as bullae, such as herpes-like pemphigus, Chronic bullous skin disease, herpes-like dermatitis, bullous epidermolysis, porphyria, pigment incontinence, mast cell hyperplasia, etc.

There are many diseases with bullae as the main manifestation, and clinical identification is also very difficult. If you have such a disease, you should go to the hospital in time, and if necessary, organize a pathological examination and immunofluorescence to confirm the diagnosis.

Diagnosis

Differential diagnosis

Blisters and bullae are easily confused, both of which are high-skinned, fluid-containing, and luminal lesions. The diameter of the blister is generally less than 1 cm, and those exceeding 1 cm are called bullae. Some scholars use 0.5cm as the boundary between blister and bullae. Pea size is often used in clinical practice to distinguish between the two.

Blisters and bullae can be distributed in isolation, such as pemphigus; or they can be clustered in clusters, such as herpes zoster. The blister contains a serum, which is light yellow; the blister contains blood, which is red (called blood blister); the blister contains lymph fluid that is clear and transparent; the blister contains pus and is turbid. Serous vesicles can become pustules or blood blister. The shape of the blister can be semi-circular, conical, oblate or irregular, and some have a umbilical fossa in the center. The blister wall can be tense and light like a balloon; it can also be loose, like wrinkled paper. Blisters can occur on normal skin, or on inflammatory skin. There can be redness around the blisters, or nothing. The blister is contained in the skin and can be divided into blister under the corner layer due to the different depth of the site, such as white peony (also in the horn layer); blister and bullae in the epidermis, such as herpes simplex, chickenpox, pemphigus, etc. Under the epidermis bullae, such as bullous pemphigoid, polymorphic erythema. The blister can be a single chamber or a multi-chamber.

Blisters can become bullies, and blisters can also be seen in bullous skin diseases. It is unscientific to separate the blisters from the big blisters. Only by correctly understanding the similarities and differences between blisters and bullae can the diagnosis be confirmed.