Vesiculobullous Skin Rash - Differential Diagnosis Algorithm
Vesicles Fragile/EasiIy Ruptured - Intraepidermal blisters, possibly crusts/erosions
- Inflammatory
• Pemphigus vulgaris
• Pemphigus foliaceus
- Infectious
• Varicella zoster (chickenpox)
• Herpes zoster (shingles)
• Herpes simplex
• Bullous impetigo
- Reaction to Agent
• Contact dermatitis
Vesicles NOT Fragile/NOT Easily Ruptured - Subepidermal blisters, tense intact blisters
- Inflammatory
• Bullous pemphigoid
• Mucous membrane pemphigoid
• Dermatitis herpetiformis
• Bullous systemic lupus erythematous
- Metabolic
• Porphyria cutanea tarda
• Diabetic bullae (bullous diabeticorum)
- Reaction to Agent
• Phototoxic drug eruption
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