Recognition of the vesiculobullous diseases is usually not difficult. Specifically, cutaneous lesions containing any number of intact, clear, fluid-filled blisters should be assigned to this group. Problems can arise if, in a blistering process, all the roofs have been broken. In this situation the presence of perfectly round erosions with a thin collarette of scale (representing the peripheral remnants of the roof) provides a clue to the vesiculobullous nature of the process. Pustular lesions should, of course, be assigned to the pustular group, but sometimes it is difficult to differentiate an aging vesicle containing cloudy fluid from a true pustule. Generally, however, true pustules are pure white or yellow-white rather than gray or cloudy. Moreover, pustules will have been white from the time of their inception. Hemorrhagic blisters can be encountered in both the vesiculobullous group and the vascular reaction group. The fact that all of the blisters are hemorrhagic, together with the presence of nearby petechiae, favors assignment to the vascular reaction group.
Tags:blisters, cutaneous lesions, hemorrhagic, peripheral, petechiae, pustule, pustules Vesiculobullous Diseases
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