Bullosis diabeticorum
Alerts and Notices
Synopsis

Bullosis diabeticorum (BD), also known as bullous eruption of diabetes mellitus or diabetic bullae, occurs in about 0.5% of diabetic patients and has an unknown pathogenesis. The co-occurrence of neuropathy and nephropathy suggests an underlying microangiopathy. The bullae are noninflammatory and asymptomatic, and they typically develop rapidly.
BD develops in long-standing, uncontrolled diabetes, although there are reports of BD as the presenting sign of diabetes. Bullae often resolve on their own without scarring, but recurrence is common, and new bullae can continue to form over a period of years. The average age of onset is 55 years, and there is a 2:1 male-to-female ratio.
BD develops in long-standing, uncontrolled diabetes, although there are reports of BD as the presenting sign of diabetes. Bullae often resolve on their own without scarring, but recurrence is common, and new bullae can continue to form over a period of years. The average age of onset is 55 years, and there is a 2:1 male-to-female ratio.
Codes
ICD10CM:
E13.628 – Other specified diabetes mellitus with other skin complications
SNOMEDCT:
48951005 – Bullosis diabeticorum
E13.628 – Other specified diabetes mellitus with other skin complications
SNOMEDCT:
48951005 – Bullosis diabeticorum
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Stasis dermatitis with bullae
- Insect bite reaction
- Bullae secondary to lymphedema
- Contact dermatitis with bullae – blisters may be linear
- Poison ivy dermatitis
- Drug eruption, bullous
- Bullous pemphigoid – differentiated by immunofluorescence
- Bullous cellulitis – will have other signs of cellulitis
- Bullous impetigo
- Bullous fixed drug eruption
- Leukocytoclastic vasculitis
- Immunoglobulin A vasculitis (formerly Henoch-Schönlein purpura)
- Pemphigus vulgaris – more likely inflammatory
- Epidermolysis bullosa acquisita – differentiated by immunofluorescence
- Porphyria cutanea tarda – more likely on the upper extremity
- Pseudoporphyria
- Bullous erythema multiforme
- Bullous tinea corporis
- Bullous amyloid
- Burn (see thermal or electrical burn; chemical burns are covered separately, by chemical agent)
- Friction blister
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Management Pearls
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Therapy
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References
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Last Reviewed:07/29/2019
Last Updated:08/07/2023
Last Updated:08/07/2023