What is the pathophysiology of bullous disease of diabetes (bullosis diabeticorum)?

Updated: Feb 04, 2019
  • Author: Maureen B Poh-Fitzpatrick, MD; Chief Editor: Dirk M Elston, MD  more...
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Answer

The pathophysiology of bullous disease of diabetes (bullosis diabeticorum) is likely multifactorial. Patients with diabetes have been shown to have a lower threshold for suction-induced blister formation compared with nondiabetic controls, [12] and because of the acral prominence of diabetic bullae, the role of trauma has been speculated.

Electron microscopic evidence has also suggested an abnormality in anchoring fibrils. However, this alone does not explain the often spontaneous development of multiple lesions at several locations.

In some patients, blisters are related to UV exposure, especially in those with nephropathy. Poor blood glucose regulation (hypoglycemia [13] and hyperglycemia [14] , or widely varying levels [13, 14] ) has been associated with blister formation.


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