Bullous Disease of Diabetes (Bullosis Diabeticorum)

Acanthosis nigricans, acrochordrons, diabetic dermatopathy, necrobiosis lipoidica, and bullous diabeticorum are some of the cutaneous symptoms of diabetes. Bullous illness (bullosis diabeticorum) is a blistering, non-inflammatory condition of the acral skin. Diabetes bullous illness is more common in people who have had diabetes for a long time or who have many comorbidities. Although the actual cause is uncertain, it is likely to be multifactorial. Neuropathy, nephropathy, vasculopathy, and UV (ultraviolet) light are all suggested to have a role. BD is most likely caused by the various problems that come with poorly managed diabetes. The exact number of people who have BD is unknown. The majority of case studies in the literature were based on a small number of cases. Bullous diabeticorum is a restrictive diagnosis, which necessitates a histological study that includes direct immunofluorescence to rule out other vesicobullous illnesses. In terms of BD management, no strong consensus has formed. The blisters have historically been thought to be self-limiting, with bullae resolving in 2 to 6 weeks if left untreated. In some cases antibiotic may be used. In this article we’ll be looking at Bullosis Diabeticorum. Its etiology, epidemiology, diagnosis, and treatment.

Clinical Characteristics, Serum Uric Acid and Bullosis Diabeticorum Outcomes in Patients With Diabetes Mellitus

Background: Bullosis diabeticorum (BD) is a spontaneous, non-inflammatory vesicular disease of diabetes, with the observed risk of infection, including diabetic skin ulcers, osteomyelitis and even leading to amputation. However, the exact cause of BD is not well understood. So the aim of this study is to explore the high-risk factors of BD for preventing its occurrence.Methods: A retrospective study was conducted, including baseline characteristics, laboratory data, and bullosis diabeticorum outcomes of 602 patients with bullosis diabeticorum. Besides, 904 diabetic patients without bullosis diabeticorum in the same period were randomly selected as the control group. The indicators of the two groups were compared. Multivariable logistic regression analysis was performed to investigate which indicator was most associated with bullosis diabeticorum outcomes.Results: SCr[145.00(69.00-195.00) μmol/L, n = 602 vs. 81.00(27.40-35.60) μmol/L, n= 904, p=0.032], BUA [674.00(372.50-758.50) µmol/L, n = 602 vs. 318.50(241.75-415.25) µmol/L, n= 904, p = 0.003] and Cys-C[1.96(1.10-2.95) mg/L, n = 602 vs. 1.49(1.10-1.62) mg/L, n = 904, p=0.004] was significantly higher in BD-positive patients than that in BD-negative patients, whereas eGFR [67.38(45.33-87.53) ml/min, n = 602 vs. 75.86(56.80-95.69) ml/min, n = 904, p=0.038] of patients with BD was significantly lower than that of patients without BD. Multiple logistic regression analysis showed that BUA, but not SCr, Cys-C and eGFR, was independently and significantly associated in a positive manner with BD (odds ratio: 8.569, 95% confidence interval: 1.136-55.250, p=0.004).Conclusion: We found a positive and independent association of BUA with BD, which provides a great clinical predictive factor for BD and helps to prevent the appearance of diabetic foot.