Bullosis Diabeticorum A Case Report with a Review of the Literature

Abstract

A case of bullosis diabeticorum is reported with a review of the literature.
A 45 year old Japanese male with onset of diabetes at age 33 and a history of poor control with insulin thereafter was admitted because of furunclosis.
Following admission and after establishment of fair control, two large bullae appeared succes sively 47 days apart without obvious cause on his left and right legs respectively. Histologically, the former was subepidermal bulla which caused ulceration and healed 2 months later with a scar. Although the latter was not biopsied, this lesion was believed to be a intraepidermal bulla because the lesion healed in 2 weeks without forming any scar. Light microscopy showed a thickening of smaller vessels in the cutis and electron microscopy of the gastrocnemius muscle revealed a marked thickening of the capillary basement membrane.
In view of these and other data, together with a review of the literature, it is suggested that this condition is related, among the various skin disorders related to vascular complications of diabetes, to diabetic microvascular lesions.