Abstract:
UNASSIGNED: Multiple pathophysiologic and biomolecular processes lead to bullae, including disruption of adhesion molecules, accumulation of cell injury, and traumatic injury. Blistering disorders of the foot can cause symptoms such as pruritus, pain, and drainage and significantly impact quality of life. Microbiologic and histopathologic examination of tissue specimens should be considered for concerns regarding atypical etiology.This retrospective case series describes patients seen in a community hospital outpatient wound center in southeastern Wisconsin between January 2021 and June 2023 for atypical blistering disorders of the foot. The cases herein describe the history, clinical presentation, and treatment of three atypical blistering disorders of the foot. An 86-year-old man presented complaining of intensely pruritic blistering lesions to both feet. Histopathologic findings indicated eosinophilic infiltrate, and the patient was treated for an eosinophilic drug reaction. A 65-year-old man presented complaining of multiple painful blisters to the plantar aspect of both feet. Histopathologic examination of unroofed blister indicated bullous tinea. Finally, a 44-year-old man with long-standing type 1 diabetes presented complaining of a several-week history of a single blister to his anterior right foot of unknown etiology. The patient was diagnosed with bullosis diabeticorum.Blistering disorders of the foot are diagnostic challenges; diagnostic clarity is assisted by thorough history, clinical presentation, treatment response, microbial analysis, and histopathologic findings.
摘要:
■多种病理生理和生物分子过程导致大疱,包括粘附分子的破坏,细胞损伤的积累,和外伤。足部起泡障碍可引起瘙痒等症状,疼痛,和排水,并显著影响生活质量。对于非典型病因的担忧,应考虑对组织标本进行微生物和组织病理学检查。这个回顾性病例系列描述了2021年1月至2023年6月在威斯康星州东南部的一家社区医院门诊伤口中心看到的非典型足部起泡疾病的患者。这里的案例描述了历史,临床表现,和治疗三种非典型足部起泡疾病。一名86岁的男子抱怨双脚剧烈瘙痒。组织病理学表现为嗜酸性粒细胞浸润,患者接受了嗜酸性粒细胞药物反应治疗。一名65岁的男子抱怨双脚的足底有多个疼痛的水泡。无顶水疱组织病理学检查提示大疱性癣。最后,一名长期患有1型糖尿病的44岁男性患者主诉其右前足有几个星期的单一水疱病史,病因不明.该患者被诊断为糖尿病性大疱病。足部起泡障碍是诊断挑战;全面的病史有助于明确诊断,临床表现,治疗反应,微生物分析,和组织病理学发现。