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Blistering diseases are defined as skin disorders that primarily give rise to vesicles (i.e. 5 mm or less in diameter) or bullae (i.e. over 5 mm in diameter). Blisters are accumulation of fluid lying within or below the epidermis.

Blistering diseases can be classified according to the site of cleavage (see Table 1).

Table 1: Causes of Blistering Diseases


A. Subcorneal Blisters:

1. Bullous Impetigo
2. Subcorneal Pustular dermatosis
3. Miliaria Crystallina

B. Intra-epidermal Blisters:

1. Acute Dermatitis
e.g. eczema, contact dermatitis
2. Pompholyx
3. Herpes infections
4. Fixed Drug eruptions (epidermal type) 
5. Friction Blisters
6. Erythema multiforme (epidermal type) 
7. Pemphigus Vulgaris

8. Epidermolysis bullosa simplex

C. Subepidermal Blisters:

1. Bullous Pemphigoid
2. Linear IgA Diseases
3. Dermatitis Herpetiformis & chronic bullous disease of childhood.
4. Erythema Multiforme (dermal type) 
5. Fixed Drug Eruptions (dermal type) 
6. Epidermolysis Bullosa

7. Bullous lupus erythematosus

8. Herpes gestationis

9. Cicatricial pemphigoid

  1. Causes of Vesicles/Bullae

I. Primary cutaneous diseases

II. Systemic diseases

A. Primary blistering diseases (autoimmune)

A. Autooimmune

1. Pemphigusa

1. Paraneoplastic pemphigusa

2.  Bullous pemphigoidb

B. Infections

3. Gestational pemphigoidb

1. Cutaneous embolib

4. Cicatricial pemphigoidb

C. Metabolic

5. Dermatitis herpetiformisb,c

1. Diabeic bullaea,b

6. Linear LgA diseaseb

2. Porphyria cutanea tardab

7. Epidermolysis bullosa Acquisitab,d

3. porphyria variegateb

B. Secondary blistering diseases

4. Pseudoporphyriab

1. Contact dermatitisa

5. Bullous dermatosis of hemodialysis

2. erythema multiforma.b

D. Ischemia 

3.Toxic epidermal Necrolysisb

1. coma bullae

C. Infections


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