Bulla repens L03.01

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 11.02.2021

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Synonym(s)

Bladder ulcer; Bulla roden; Circulation; festering finger blister; Staphylodermia superficialis bullosa manuum; Streptodermia superficialis bullosa manuum; Tourniole (Sabouraud)

Definition
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Acute, vesicular, superficial form of an acute paronychia. Bulla repens can also be described as a special form of (blistered) Impetigo contagiosa on the groin skin.

Pathogen
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Staphylococcus aureus, rarely strep.

Etiopathogenesis
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The clinic of bulla repens, as pyoderma of the groin skin, is defined by the anatomical peculiarity of the groin skin. The purulent exudation of the dermis leads to a subepithelial pustule with a "thick" stratur corneum forming the cover. Since this does not burst in contrast to the thin field skin, the exudation can only migrate subepithelially. A large, bulging pus blister is formed. At the tip of the finger or toe there is a "circulating" blister which is in reality a pustule.

Localization
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Skin areas with a thick horny layer, especially palmae, plantae, volar sides of the fingers, fingertips and nail wall ( paronychia).

Clinical features
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Mostly solitary, mostly turgid blister surrounded by an inflammatory cavity with initially clear contents, later purulent clouding (pus blister). There is a tendency to grasp the nail (circulation). Possible involvement of the nail fold and bed with loosening or detachment of the nail.

Differential diagnosis
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Complication(s)
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Transition to panaritium or phlegmon.

External therapy
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  • Opening of the bladder, removal of the bladder cover, baths with aqueous quinolinol solution(e.g. Chinosol 1:1000), R042, diluted potassium permanganate solution (light pink), ointment therapy with iodine-polyvidone ointment (e.g. R204, Braunovidon).
  • Apply sterile dressings with gauze grid (e.g. Hansaplast), if necessary use gauze grid with antibiotic additives (Fucidine gauze, Branolind). Removal of ointment residues with iodine-polyvidone solution (e.g. Braunoderm).

Internal therapy
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Antibiotic treatment with a cephalosporin such as cefadroxil (e.g. Cedrox) once/day 1 g p.o. or cefuroxime (e.g. Elobact) twice/day 250 mg p.o.

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 11.02.2021