A 62-year-old man with long-standing poorly controlled type 2 diabetes presents with painless, tense, non-inflammatory blisters up to 4 cm in diameter over the dorsal feet and lower legs that appeared suddenly. There is no trauma history and mucosae are spared. Which of the following best describes this condition?

• A It is caused by staphylococcal exotoxin and spares the extremities
• B It shows subepidermal split with linear IgG along the basement membrane
• C It requires systemic corticosteroids to prevent scarring
• D It heals without scarring and is linked to neuropathy and nephropathy ✓

Explanation

Bullosis diabeticorum occurs in long-standing diabetics with peripheral neuropathy and often nephropathy; large painless tense blisters appear on acral skin and usually heal spontaneously within weeks without scarring. It kills the pemphigoid distractor because direct immunofluorescence is negative, unlike bullous pemphoid which shows linear IgG and C3 at the basement membrane zone.

Reference: Bolognia, Dermatology, 5th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.