Bubble (damage)
A bubble is a cavity cutaneous large (greater than 5 mm) causing an uprising circumscribed epidermal containing a collection of clear fluid, serous, inflammatory, or hemorrhagic.
Etymology
   * Lang: lat: bulla: decoration shaped ball
   * Lang: fr_vx: Buille: Seal
Definition of the bubble in dermatology
The elementary lesion of Dermatology is caused by a delamination between different layers of the skin (epidermis, dermis, hypodermis).
We can highlight the fragility of the epidermis by searching the Nikolsky sign. This sign is characteristic of a loss of adhesion between keratinocytes of the epidermis. It is absent in diseases responsible for a rift between dermis and epidermis.
You should know suggest the diagnosis before the bubble:
   * Erosions post-bullous
   * Ulcers,
   * Sometimes extensive skin undermining,
   * Or crusts.
Localization of bullous lesions
   * Reached mucosa, eye, mouth, genitals
   * Full skin lesions, facial (peri-orifice, temples ..), roots of the limbs, extremities, areas of friction, the photo-exposed areas ...
Evolution
The bubbles can leave scars, adhesions, including bubble OPHTHALMIC.
Differential diagnosis
   * Skin lesions forming a cavity containing the liquid which are not bubbles:
         o gall smaller for making 1 to 3 mm in diameter,
         o the pustule, which is a bubble containing pus, or microbial amicrobien
         o the cyst, which is a bubble with a wall cleaner,
   * Skin lesions not containing liquid:
         o nodule
         o infiltrate,
         o sclerosis,
Headquarters histological detachment
For some writers, the bubble is epidermal or subepidermal (dermal-epidermal junction), and not dermal or hypodermal. The headquarters detachment is variable:
   * Intra-epidermal
   * Sub-epidermic cleavage in the area of dermo-epidermal junction:
         o lamina lucida
         o basement membrane
         o necrosis of epidermal basal seat.
Classification according to the seat histological
* Bubble intra-epidermal:
         No acantholysis by:
         o by ballooning degeneration:
               + Varicella
               + Zoster
               + Herpes
         o cell necrosis:
               + Toxidermie,
               + Erythema multiforme,
         o by spongiosis:
               + Bullous prurigo;
   * Bubble subepidermic:
         o disease-Dühring Brocq,
         o epidermolysis bullosa,
         o porphyria.
Etiologies
   * Caused by an external agent:
         o traumatic:
               + Bulbs
               + Epidermolysis bullosa,
         o heat:
               + Burns:
                     # Sunburn,
                     # Other burns
               + Frostbite
         o chemical contact dermatitis: allergic, irritant, caustic,
         o parasite: parasitic prurigo
         o Plant: dermatitis meadow Oppenheim,
   * Drug:
         o toxidermas bullosa:
               + Toxidermie recurrent pigmented,
               + Toxidermie bullous polymorphous
               + Halaal bullous
   * Toxidermas to type of erythema multiforme,
   * Lyell's syndrome toxic
   * Infections:
         o impetigo
         o virus:
               + Herpes
               + Zoster
               + Orf
   * Erythema multiforme,
   * Lyell's syndrome:
         o drug (toxicity)
         o staphylococcal
   * Pemphigus,
   * Pemhigoïdes:
         o bullous pemphigoid,
         o herpes gestationis called pemphigoid gestationis
         o cicatricial pemphigoid,
   * Dermatitis herpetiformis
   * Porphyria cutanea tarda,
   * Epidermolysis bullosa.
See also Dermatologist
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