Bubble (damage)

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.


* 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 ...

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.


* 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