Bullous dermatitis is a skin disease of allergic origin. It is characterized by a lesion of the skin and the appearance of specific water bubbles on it. As a rule, this disease occurs under the influence of a strong external allergic stimulus. True, bullous dermatitis can be a manifestation of endocrine, genetic or metabolic disorders or diseases. Diagnosis of bullous dermatitis is designed to identify exactly the factor that led to the development of the inflammatory process, and to conduct a number of laboratory studies, including a biopsy. Treatment of the disease is reduced to eliminating the action of the allergen.
The content of the article:
Causes of bullous dermatitis
Symptoms of bullous dermatitis
Diagnosis of bullous dermatitis
Treatment of bullous dermatitis
Bullous dermatitis
Bullous dermatitis manifests itself in the form of water bubbles. In medicine, these formations, depending on the size, are called vesicles or bulls. Vesicles are less than 5 mm in size, and bullae are more than that. A feature of bullous dermatitis is interepidermal (in the epidermis) or the subepidermal (under the epidermis) location of the blisters. Intraepidermal blisters are characteristic of Hayley-Hayley disease and erythroderma bullosa. Subepidermal placement of bladders is also inherent in other similar diseases
Causes of bullous dermatitis
Modern medicine identifies internal and external factors of the development of bullous dermatitis.
External factors include the following:
sudden temperature changes;
ultraviolet radiation;
exposure to sunlight;
strong medications;
aggressive chemicals (turpentine, hair dye, ursol and others).
Internal factors:
genetic abnormalities (congenital erythroderma, Hayley-Hayley disease, epidermolysis bullosa);
metabolic disorders (porphyria, pellagra);
inflamed dermatoses (bullous pemphigoid, pemphigus, bullous systemic lupus, allergic contact dermatitis);
infectious diseases (impetigo herpes, bullous dermatophthia).
Depending on the cause of development , the following types of bullous dermatitis are distinguished:
sunny;
temperature;
diabetic;
chemical;
metabolic;
hereditary.
Accordingly, each of the types of bullous dermatitis has different symptoms that need to be distinguished.
Symptoms of bullous dermatitis
Prolonged direct exposure to the sun’s rays on the skin after a while can cause bullous dermatitis. Initially, the skin turns red, then bubbles appear, having different sizes and shapes. Solar dermatitis is characterized by an increase in temperature, itching, deterioration of well-being, burning and other symptoms. Traces of hyperpigmentation remain in place of the bubbles.
A sharp decrease in temperature leads, as is known, to frostbite, which provokes temperature bullous dermatitis. First of all, there is a vasospasm. After a certain period of time, vasodilation is observed, the skin turns red, painful sensations appear. At the same time, there are edema and bubbles containing bloody or serous fluid inside. In place of the bubbles, erosions occur, which are covered with skins after healing. Also, high temperature can cause burns of varying degrees of complexity. With such skin injuries, the symptoms are very similar to those of frostbite, however, bubbles appear almost immediately after contact with a fire source. Accordingly, bullous dermatitis can occur both in the case of a grade II burn and frostbite.
Chemical bullous dermatitis manifests itself only on those parts of the skin that were in direct contact with the irritant. After a while, the defeat may take on a generalized character. For example, ursol causes blisters on the neck and face, and there is also severe swelling around the eyes.
Metabolic disorder, or endocrine disease, causes metabolic dermatitis. Diabetes mellitus of any type can provoke the development of diabetic dermatitis. In this case, the bubbles are localized on the hands and feet. Enteropathic acrodermatitis is also isolated, which is characterized by zinc deficiency in the body. That is why bubbles appear around the eyes, in the mouth, on the limbs, lips, and the like.
If we take into account hereditary bullous dermatitis, then it usually manifests itself immediately after birth. Blisters may suddenly appear on the site of small skin lesions. For example, Hayley-Hayley disease is transmitted at the genetic level, but its symptoms are very similar to pemphigus.
Diagnosis of bullous dermatitis
The dermatologist initially studies the clinical picture, paying attention to the number of formations, their size, location, and so on.
It is important to identify the provoking factor during surveys and studies. In the case of the infectious nature of the disease, it is necessary to carry out seeding and bacterioscopy of the liquid contained in the bubbles.
Biopsy and histological examination can be called the most informative methods in the diagnosis of bullous dermatitis. To do this, you need to take a fresh bubble and the skin around it. Indirect or direct immunofluorescence will help determine the nature of the origin of the disease.
Hereditary dermatitis requires electron microscopic studies. If doctors suspect porphyria, the patient needs to donate urine to determine the level of porphyrins. The concentration of zinc in the blood is determined to confirm or refute the suspicion of enteropathic acrodermatitis.
Treatment of bullous dermatitis
The main principle in the treatment of bullous dermatitis is called the elimination of the provoking factor. If dermatitis has arisen under the influence of other diseases, then, accordingly, you need to take up their treatment.
Symptomatic treatment should be carried out if a hereditary type of bullous dermatitis has been diagnosed.
Internal and external drug therapy is important. Treatment includes antihistamines, sedatives, anti-inflammatory mixtures, antibacterial and corticosteroid ointments, means for healing erosions, etc. For this purpose, such drugs as beloderm, betaspan, prednisolone, lemod, methyluracil 10% are ideal.
Physiotherapy may also be required, carried out using ultrasound, magnetic field, laser and electric current. Each procedure is selected individually for the patient.
It may also be necessary to open the bubbles, while strictly observing all the rules of sterile treatment.
