Bullous dermatitis — signs, photos, treatment methods

Characteristics and classification
Causes of bullous dermatitis
The main signs of illness
Diagnostic methods
Therapeutic methods
Traditional medicine
Preventive measures

Characteristics and classification

More than 5 mm in diameter bubbles appear on the surface skin layer or in its depth, serous and/or hemorrhagic mass could be seen inside the cavity.

Bubble structure:

  1. Sealing is formed from above.
  2. Cavity with liquid contents.
  3. The bottom of the bulla is located more deeply.

The place of the bursting bubble on the epidermis turns into erosion, which is covered by a characteristic crust. As a result of effective treatment, the skin is restored. The consequence of opening the bullas in the lower layers is an ulcer. It heals longer and leaves scars, they are called atrophic pits.

The disease can spread to different parts of the body. The most unpleasant thing that often the BD occurs on the face.

Bullous disorders are identified by ICD-10 code L10-L14.

Regarding stimuli, skin pathology is classified according to the following parameters:

  • Contact bullous dermatitis — a reaction of the epidermis to the contact with aggressive acids, alkalis, salts.
  • Phototoxic — an influence of ultraviolet rays.
  • Allergic — tactile contact, the evaporation of harmful chemicals, plant pollen, some metal alloys.
  • Temperature — severe frost, liquid nitrogen frostbite, sunburn, and thermal burns.
  • Mechanical — corns, diaper rash, as a result of the friction of the skin.
  • Metabolic — dysfunction of organs responsible for metabolic processes.
  • Infectious — effects of dermatophyte fungi, herpes virus, pathogenic bacteria.
  • Enteropathic — lack of zinc.
  • Mixed — a combination of motivating factors.

Bullous dermatitis can occur with birth (for hereditary reasons) and throughout life (acquired species). The first group includes epidermolysis bullosa, pemphigoid, erythroderma, Hailey-Hailey pathology. The second type of bullous dermatitis is possible with interactions with the external environment.

In the photo bullous dermatitis in children:

Bullous dermatitis in a child
Bullous dermatitis in a child

Here are subspecies of the type of disease in question:

  • Duhring disease is a herpetiform, characterized by the presence of flaky scales;
  • Ritter’s dermatitis is a severe form caused by single or combinations of infections (Staphylococcus and/or streptococcus). It affects children, this form can be lethal.

Causes of bullous dermatitis

The disease is provoked by external and internal factors.

External considered as follows

  1. Long-term use of antibiotics; intolerance to the components that make up the drugs.
  2. Exposure to bright sunlight.
  3. Skin lesions with turpentine, ammonia, hair dye, and other inorganic compounds.
  4. Ultraviolet rays (natural or artificial).
  5. Excessively low or high air temperature.
  6. Means of decorative and medical cosmetics.
  7. Latex.
  8. Nickel-containing accessories.
  9. Contact with individual plant species.

Internal factors include:

  1. Herpes virus.
  2. Exacerbation of allergic reactions.
  3. Porphyria is impaired iron metabolism.
  4. Diabetes mellitus shows itself as a violation of metabolic processes.
  5. Impetigo.
  6. Anomalies of the genetic level, transmission of the disease are possible by inheritance.
  7. Lupus.

Internal causes are more serious, because they can not be prevented, and you have to deal with their consequences. They practically do not depend on human behavior.

Many of the external causes can be prevented. The human factor plays a role here, which is an indirect motivator for the acquisition of such an unpleasant disease.

The main signs of illness

Bullous dermatitis is outwardly expressed by reddening spots, the appearance of bulls. Inside the cavity, a liquid can be observed, in its composition — lymph, plasma, blood. From the concentration of the listed components, the contents may be transparent yellow, with a red or black tinge.

Symptoms vary according to the form of the BD:

– chemical — the occurrence of puffiness on the face and neck, resulting from contact with reagents.

– temperature — the appearance of large bubbles characteristic of burns or frostbite. Wrinkled outside, they are filled with serous fluid. The patient experiences tingling pain in the affected areas.

– hereditary — congenital, its activity provokes injuries of the epidermis, which by nature has genetic defects.

– enteropathic — due to zinc deficiency, the main symptoms are noticeable around the mouth, eyes, on the extremities.

In the photo, bullous dermatitis in adults, timely treatment gives positive results:

Bullous dermatitis in an adult
Bullous dermatitis in an adult

– in cases of diabetes — bullae with clear watery fluid on the limbs.

– solar-type — red spots, itching and burning, general weakness, blisters occur in 2-3 hours after irradiation. A person feels the heat and tightness of the skin due to high dryness.

The photo shows the symptoms of blistering bullous dermatitis:

Symptoms of blistering bullous dermatitis
Symptoms of blistering bullous dermatitis

– contact — redness, vesicles appear.

– An allergic form is expressed only by hyperemia and severe itching.

The most dangerous is bullous exfoliative dermatitis in infants. This ailment is expressed by blistering all over the skin. Often leads to sepsis, a high probability of death.

In the photo bullous dermatitis in adults:

bullous dermatitis photo

Diagnostic methods

A dermatologist conducts an examination, evaluates external signs, and studies the symptom characteristics. In the process of visual examination of the patient’s skin, the specialist draws attention to the symmetry of the bubbles’ location, their size, and the state of the mucous membranes.

The preliminary diagnosis is clarified by determining the causes of which the doctor learns from the conversation with the patient. In addition to the information received, it is necessary to collect data from laboratory studies:

  • If an infectious nature of the disease is suspected, the contents of the cavities on the skin should be sown to determine the exact infectious agent.
  • Histological examination of tissues.
  • Jadassohn test, in order to exclude Duhring disease.
  • The appointment of the immunofluorescence to set an indicator of allergies.
  • The presence of porphyrins, by the conducting of urine and blood tests.
  • Determination of sugar and zinc concentrations.
  • To reveal or disprove the presence of herpes antibodies in the blood.
  • Electron microscopic methods allow diagnosing a hereditary disease.

Collecting a full history allows you to make a final diagnosis and make the correct course of treatment.

Therapeutic methods

The primary thing in the bullous dermatitis treatment is the elimination of the stimulus, and only after some time, if necessary, drug therapy can be prescribed.

If the BD is a consequence of dysfunction of the internal organs and systems, the appropriate therapy is carried out first.

The treatment is performed by a specialized physician regarding the causes and characteristics of the course of the disease. This may be a pediatrician, infectious diseases specialist, allergist or dermatologist.

In case of an allergic BD, it is necessary to get rid of the allergen.

Symptomatic treatment is indicated for the hereditary form of BD.

In cases of porphyria, it is necessary to start the process of normalization of iron metabolism.

Stabilization of carbohydrate metabolism is connected with sugar disease.

In regard to burns, the elimination of temperature or chemical factors should be conducted.

After the elimination of all causal factors and triggers, the patient undergoes procedures and takes medications. In milder forms, treatment is carried out on an outpatient basis, in advanced stages, it should be conducted in the hospital.

The treatment program is developed separately for each patient. Common methods include:

  • Drying of affected weeping areas with chlorhexidine, hydrogen peroxide.
  • Opening the bullas is allowed only in the hospital.
  • After the excision of the blister sealings, the patient remains under medical supervision, he is bandaged every day. Antiseptics will be needed to prevent suppuration and for the treatment of wounds. But they have to be alcohol-absent, so as not to cause additional irritation.
  • Some bullas are not opened at the discretion of the doctor. They are treated by external remedies containing hormone-glucocorticosteroids, like Triderm, Dexamethasone, Elocom, Medrol, Flumethasone; non-hormonal drugs, such as Skin cap, Cinocap
  • Zyrtec, Incidal, Allegra syrups are recommended for patients suffering from severe itching. For this purpose, antihistamines are prescribed.
  • To improve the regeneration of the skin the next external agents can be used: Bepanthen, Epidel, Exoderil.
  • Such immunosuppressants as Myelosanum, Leukeran, Cyclophosphamide help to weaken the skin reaction to the allergen.
  • To relieve anxiety causing insomnia, sedatives are prescribed, such as Sedasen, Persen.
  • Patients with more severe forms of the disease need more potent drugs, like Metypred, Dexamethasone, and Methotrexate.

The passage of such physical procedures as magnetic therapy, ultrasound, are recommended to enhance the regenerative function of the skin.

Plasmapheresis is prescribed to reduce the likelihood of relapse.

With the hereditary nature of the disease, hormonal drugs, cytostatic and immunosuppressive are shown (Ciclosporin and Azathioprine). They help to relieve aggravation and go into remission.

Betaspan, Lemod, Celestone ointments are used to enhance the healing effect.

Infection cannot be beaten without antibiotics from the category of cephalosporin and penicillin.

Painkiller tablets, such as Ibuprofen and Voltaren relieve pain and suppress inflammation.

In the case of chemical or thermal BD, the patient is placed in the burn ward. The course of treatment is carried out according to an individually developed scheme with antibiotics, the patient receives polyionic intravenous solutions by drip.

Traditional medicine

There is no disagreement between the opinions of official doctors and healers from the people because the traditional methods really give the expected effect. The only reasonable condition is the control of professional specialists.

Infusions, decoctions, homemade ointments are especially effective in the treatment of BD.

Antiseptic Thyme

It is enough to take 250 ml of water, 1 tbsp. of dry thyme plants, reduce by half the volume, in the remaining broth add the same oil base (vegetable or butter), shake and the drug is ready.

Hypericum сream

One part of boiled natural juice of a medicinal plant (you can take flowers, leaves, and stems) is combined with 4 parts of butter into a homogeneous mass. Use as a normal ointment.

Natural Juices

Freshly squeezed juices from potatoes, apples, cucumbers are miraculous remedies for beating rashes and restoring epithelium.

Preventive measures

Preventive methods can help with the occurrence of skin disease. It is worth starting with the exclusion of irritating elements, like chemical or food allergens. If the stimulants of the disease are associated with a professional activity, he needs such items of protection as a bathrobe, respirator, gloves, shoe covers. By the way, recommendations of this kind are included in the basic rules of work organization. They must be observed by everyone working in hazardous industries.

Fulfillment of the safety conditions at a hazardous enterprise (behavior under the action of low and/or high temperatures, harmful fumes, exposure to aggressive chemical compounds) is a guarantee to protect oneself from probable skin disease.

In everyday life, preference should be given to detergents and cleaning products with a hypoallergenic label. Wash personal items with gentle washing powders and gels.

If the body does not tolerate contact with synthetic fabric, you need to change clothes to natural. The material must have sufficient air permeability and must not contain chemical irritants, in particular, dyes.

Personal hygiene is an important part of prevention. No less important is the advice — do not take any pharmacological drugs without a doctor’s recommendation.

Genetically predisposed body is not recommended abusing by sunbathing in the open sun. Frostbite is also risky for those prone to temperature allergies.

A calm emotional state is the main condition for avoiding a skin rash that easily arises as a result of the stress experienced.

With extremely careful attention to their own health, a person can fully expect that the BD will not touch him.


Before we talk about projections, we need to return to the idea that the earlier we pay attention to the first signs of an illness, the easier it will be to get rid of it. In this case, positive predictions do not cause doubts.

But if you let the process take its course, neglect the first symptoms, you guarantee a complication for yourself.

Fortunately, now there are no problems with the supply of medicines, this makes possible to strictly follow all medical recommendations. This is the answer to the question of projections because the timely receipt of the necessary pharmacological preparations can provide the desired result.

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