Vesicular-Bullous-Pustular Skin Lesions


Primary Mucocutaneous Disease

Primary Automimmune Bullous Disease

  • Bullous Pemphigoid (see Bullous Pemphigoid, [[Bullous Pemphigoid]]): subepidermal
  • Cicatricial Pemphigoid: subepidermal
  • Dermatitis Herpetiformis: subepidermal
    • Associated with gluten enteropathy
  • Epidermolysis Bullosa Acquisita: subepidermal
    • Associated with inflammatory bowel disease
  • Gestational Pemphigoid: subepidermal
  • Linear IgA Bullous Dermatosis: subepidermal
  • Pemphigus Vulgaris (see Pemphigus Vulgaris, [[Pemphigus Vulgaris]]): intraepidermal

Secondary Bullous Disease


  • Blistering Distal Dactylitis
  • Bullous Impetigo (see Impetigo, [[Impetigo]]): intraepidermal
  • Cellulitis (see Cellulitis, [[Cellulitis]])
  • Cold Sore
  • Ecthyma Gangrenosum (see Ecthyma Gangrenosum, [[Ecthyma Gangrenosum]])
  • Erysipelas (see Erysipelas, [[Erysipelas]])
  • Gas Gangrene: Clostridium species (see Gas Gangrene, [[Gas Gangrene]])
  • Hand, Foot, and Mouth Disease (see Hand, Foot, and Mouth Disease, [[Hand, Foot, and Mouth Disease]])
    • Coxsackie A Virus (see Coxsackie Virus, [[Coxsackie Virus]]): Coxsackie is an Enterovirus family member
    • Enterovirus 71 (EV-71) (see Enterovirus 71, [[Enterovirus 71]]): Enterovirus 71 is an Enterovirus family member
  • Herpes Simplex Virus (HSV) (Herpes Gladiatorum, Herpetic Whitlow) (see Herpes Simplex Virus, [[Herpes Simplex Virus]]): intraepidermal
    • May also occur with systemic disease
  • Molluscum Contagiosum: pox-like virus
  • Necrotizing Fasciitis (see Necrotizing Fasciitis, [[Necrotizing Fasciitis]])
  • Orf: parapox virus
  • Rickettsial Pox: Rickettsia akari
  • Smallpox (see Smallpox, [[Smallpox]]): variola virus
  • Staphylococcal Scalded Skin Syndrome (see Staphylococcal Scalded Skin Syndrome, [[Staphylococcal Scalded Skin Syndrome]]): due to Staph aureus (see Staphylococcus Aureus)
    • Intraepidermal
    • In adults, associated with renal failure and immunocompromised state
  • Varicella-Zoster Virus (Chickenpox and Shingles) (see Varicella-Zoster Virus, [[Varicella-Zoster Virus]]): intraepidermal
    • May also occur with systemic disease
  • Vibrio Vulnificus (see Vibrio Vulnificus, [[Vibrio Vulnificus]])

Systemic Disease


  • Paraneoplastic Pemphigus: intraepidermal
  • Small Vessel Vasculitis (see Vasculitis, [[Vasculitis]]): deeper dermal small vessel vasculitis typically results in vesicular-bullous or palpable purpuric skin lesions


  • Cutaneous Emboli (see Endocarditis, [[Endocarditis]]): subepidermal

Metabolic Disease

  • Bullous Dermatosis of Hemodialysis: subepidermal
  • Diabetic Bullae (Bullosis Diabeticorum) (see Diabetes Mellitus, [[Diabetes Mellitus]]): intraepidermal or subepidermal
  • Porphyria Cutanea Tarda: subepidermal
  • Porphyria Variegata: subepidermal
  • Pseudoporphyria: subepidermal



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