153 Bullous eruption
Salient features
Examination
• Bullous eruption (Fig. 153.1)
• Crusts or superficial erosions (these suggest a preceding fluid-filled lesion).
• Comment on the distribution: knee, thighs, forearms and umbilicus in the elderly (pemphigoid).
• Look in the mouth for ulceration; if the blisters break easily leaving denuded skin, it is more likely to be pemphigus.
• Tell the examiner that a biopsy of the skin is essential to confirm the diagnosis.
