a60 year male patient with blisters in whole body since 2-3 weeks .k/c/o DM since 10 years blood culture and culture of serous from blisters negative diagnosis? management?

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It is bullous pemphigoid...as the bullas in pemphigus tend to rupture easily...and age of onset also late which is again char for bullous pemphigoid. Bullas in pemphigus tend to rupture as membrane coating them is thin, as damage is in transmembrane desmosomal glycoproteins, which leads to keratolysis. And in case of bullous pemphigoid the damage is in subunits of hemidesmosomes which anchor the basal keratinocytes(epidermis) to basement membrane. So the membrane coating the bullas is more thick. Nikolsky sign is positive in pemphigus and negetive is pemphigoid. Treatment with systemic and local GCS.

It ia wise to consider methotrexate as an option in given case as an adjunctive to steroids to decrease the dose of steroids. But again need evaluate the case and depending on blood glucose and lft status treatment should be decided.
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Dear curofy manager. Again u did it. The first made diagnosis of bullous pemphigoid in this case(Mine) u dragged to the lost while those commented/ repeated u have placed in the beginning. Besides u have loop- lined my reply without any basis tied with other 'conversation' zThus u have robbed the credit of first made correct diagnosis. Pl correct now and for ever...urs sincerely...Dr ASV PRASAD.

Dear curofy manager..uhave yet to act and gets myright priority of order . It may not bother to curofy and others .(especially when their agreement score increases). I insist my right though it matters little even ic u don't comply.@@Dr Seepuru krisnamohan to 'induce' curofy to follow the order of cases ss they r posted. Pl feel tagged.

Unfortunately treatment of bullous pemphigoid is steroids that aggravate diabetes

Dapsone may be an alternative.
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Most likely pemphigus . Other similar conditions must be ruled out. Any drugs prior to this condition must be known, to make sure Not drug induced . Must be managed by senior dermatologist, since diabetic .

Phemphigous. Treat ..prednisolone Antihistamines Ampicillin500mgxtdsx7days

bullous pemphigoid

It looks like a case of Bullasimpetigo/ Phemphigus Rx C/ S of Bullasimpetigo fluid appropriate antibiotic,local sofratule dressing s, tab Montalucas1 bd

pamphigus?

Does he have h/o blister or sours in mouth?
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