BỆNH DA BỌNG NƯỚC DO ĐÁI THÁO ĐƯỜNG (BULLOSIS DIABETICORUM): CA BỆNH LÂM SÀNG

Abstract

Objective: To describe the clinical, paraclinical characteristics, and treatment of a case of bullosis diabeticorum at Hanoi Dermatology Hospital. Subjects and Methods: Descriptive case report. The patient was a 67-year-old male with a history of diabetes for over 30 years, with blood glucose levels ranging from 5-10 mmol/L. He presented with a sudden onset of scattered blisters on the left thigh. Initially, he was misdiagnosed with herpes zoster and pemphigus vulgaris at a lower-level facility and treated with acyclovir and systemic corticosteroids at moderate doses, without improvement. Histopathology revealed clear and subepidermal blisters without acantholysis; cytology of the blister fluid showed similar findings. Direct immunofluorescence of perilesional skin was negative for IgA, IgM, IgG, C3, and fibrin. Results: The patient was diagnosed with bullosis diabeticorum, a rare complication in long-standing diabetes that can be mistaken for autoimmune blistering dermatoses. Histopathology and direct immunofluorescence are essential for definitive diagnosis. Treatment primarily involves glycemic control and local wound care. Conclusion: This case highlights the importance of raising clinical awareness for the differential diagnosis between bullosis diabeticorum and autoimmune blistering disorders, avoiding unnecessary immunosuppressive therapy.