Bullous lesions in diabetes mellitus: bullous diabeticorum (diabetic bulla)

A 55-year-old woman was referred to dermatology services for evaluation of recurrent, asymptomatic, tense bullous lesions on her legs bilaterally. There was no history of any trauma or insect bites. There were no systemic complaints. The lesions used to heal spontaneously. The patient was a known ca...

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Bibliographic Details
Published in:BMJ case reports 2020-08, Vol.13 (8), p.e238617
Main Authors: Kansal, Naveen Kumar, Anuragi, Ramesh Pratap
Format: Article
Language:English
Subjects:
Asymptomatic
Blister - etiology
Blister - physiopathology
Case reports
Dermatology
Diabetes
Diabetes Complications - diagnosis
Diabetic neuropathy
Female
Humans
Images In
Middle Aged
Skin diseases
Skin Diseases - etiology
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Summary:A 55-year-old woman was referred to dermatology services for evaluation of recurrent, asymptomatic, tense bullous lesions on her legs bilaterally. There was no history of any trauma or insect bites. There were no systemic complaints. The lesions used to heal spontaneously. The patient was a known case of type 2 diabetes mellitus for the last 8 years and was on oral hypoglycaemic medications (tab. metformin 1 g twice daily) and was well controlled. The complete blood counts, liver and kidney function tests, urine examination and fasting blood glucose (99 mg/dL) were within normal limits. On physical examination, a circular, fluid-filled, flaccid blister was present on non-erythematous skin of the left shin (figure 1). Few scars were present on the shin due to similar earlier lesions. There was no evidence of diabetic neuropathy. Based on the history and examination, a clinical diagnosis of bullous diabeticorum (diabetic bulla) was made. The patient was counselled, and no active intervention was performed.1 2 The lesions healed in due course without any complications. The patient is in regular follow-up at the diabetes clinic.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2020-238617