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Vesiculobullous Disorders

»	What is the difference between a vesicle and a bulla?
»	How are the bullous diseases defined?
»	What things cause vesicles and bullae?
»	How do you approach a patient who presents with an acute onset of a vesiculobullous eruption?
»	Which skin findings are helpful in evaluating a patient with blisters?
»	Do particular vesiculobullous diseases occur in characteristic distributions?
»	Which tests are most useful in evaluating vesiculobullous diseases?
»	How should a skin biopsy of a vesiculobullous eruption be performed?
»	When are special tests necessary to diagnose blistering diseases of the skin?
»	How are specimens obtained for direct immunofluorescence?
»	For which vesiculobullous diseases are indirect immunofluorescence helpful?
»	List the most common blistering diseases due to external agents.
»	Name examples of drugs that can cause vesiculobullous eruptions.
»	What is epidermolysis bullosa?
»	Describe the other genetic blistering diseases.
»	List the vesiculobullous diseases caused by metabolic disorders.
»	Describe the clinical findings in bullous diabeticorum.
»	What is the cause of pellagra?
»	What is the difference between porphyria cutanea tarda and pseudoporphyria?
»	What are the necrolytic erythemas?
»	What is the difference between bullous pemphigoid and cicatricial pemphigoid?
»	How do pemphigus vulgaris and pemphigus foliaceus differ?
»	Linear IgA bullous dermatosis occurs in two different clinical situations. What are they?
»	Describe the clinical findings in dermatitis herpetiformis.
»	Does herpes gestationis have anything to do with herpes viruses?
»	What is bullous systemic lupus erythematosus?
»	What is epidermolysis bullosa acquisita?

Do particular vesiculobullous diseases occur in characteristic distributions?

See Table 10-3.

Table 10-3. Characteristic Distribution of Vesiculobullous Diseases
	DISEASE	CHARACTERISTIC DISTRIBUTION
	Acrodermatitis enteropathica	Acral, periorificial
	Allergic contact dermatitis	Reflects pattern of contact; often linear
	Bullous dermatophyte infection	Feet, hands
	Bullous diabeticorum	Distal extremities
	Bullous pemphigoid	Flexural areas, lower extremities
	Cicatricial pemphigoid	Eyes, mucous membranes
	Dermatitis herpetiformis	Elbows, knees, buttocks
	Erythema multiforme	Acral areas, palms, soles, mucosa
	Hailey-Hailey disease	Intertriginous areas, neck
	Hand, foot, and mouth disease	Mouth, palms, fingers, soles
	Herpes zoster	Dermatomal distribution
	Linear IgA bullous dermatosis (childhood type)	Groin, buttocks, perineum
	Pemphigus vulgaris	Oral mucosa, other sites
	Pemphigus foliaceus	Head, neck, trunk