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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?

Name examples of drugs that can cause vesiculobullous eruptions.

See Table 10-5.

Table 10-5. Drugs That Can Cause Vesiculobullous Eruptions
	ERUPTION	OFFENDING DRUG(s)
	Bullous pemphigoid	Tetracycline, furosemide, ibuprofen and other nonsteroidal antiinflammatory drugs (NSAIDs), captopril, penicillamine, and other antibiotics
	Erythema multiforme	Anticonvulsants, barbiturates, sulfonamides, NSAIDs, antibiotics
	Linear IgA bullous dermatosis	Vancomycin, lithium, captopril, antibiotics
	Phototoxic drug eruption	Psoralens, thiazides, furosemide, fluoroquinolones, doxycycline (and other TCNs), sulfonamides
	Porphyria-like drug eruption	Furosemide, tetracycline, naproxen
	Toxic epidermal necrolysis and Stevens-Johnson syndrome	Anticonvulsants, sulfonamides, NSAIDs, allopurinol, antiretrovirals

TCNs, tetracyclines.