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[Encyclopedia of Differential Diagnosis in Dermatology] Paul Schneiderman, Marc E. Grossman - A Clinician\'s Guide to Dermatologic Differential Diagnosis, Volume 1 The Text (Encyclopedia of Differential Diagnosis in D

BULLAE, HEMORRHAGIC
99
Schneiderman page 1-100.qxd 5/16/2006 6:49 PM Page 99


Iododerma 
Australas J Dermatol 28:119–122, 1987
Linear IgA disease – somatostatin, vancomycin, captopril,
phenytoin, lithium, diclofenac, cefamandole, amiodarone,
furosemide 
JAAD 41:103–105, 1999; Clinics in Derm
11:529–533, 1993
Penicillamine – hemorrhagic bullae of dorsum of feet 
AD
95:196–198, 1967
PPD reaction – bullous
Vasculitis, leukocytoclastic – drug-induced
INFECTIONS AND/OR INFESTATIONS
Aeromonas sobria Pathol Int 49:541–546, 1999
Anthrax – 
Bacillus anthracis; malignant pustule; face, neck,
hands, arms; starts as papule then evolves into bulla on red
base; then hemorrhagic crust with edema and erythema with
small vesicles; edema of surrounding skin 
Am J Dermatopathol
19:79–82, 1997; J Clin Inf Dis 19:1009–1014, 1994; Br J
Opthalmol 76:753–754, 1992; J Trop Med Hyg 89:43–45, 1986;
Bol Med Hosp Infant Mex 38:355–361, 1981
Aspergillosis – primary cutaneous 
JAAD 38:797–798, 1998;
primary cutaneous aspergillosis in premature infants 
Ped Derm
19:439–444, 2002; AD 136:1165–1170, 2000; JAAD
12:313–318, 1985; sepsis in leukemic patients AD
141:633–638, 2005
Brucellosis
Capnocytophagia canimorsus
Caterpillar dermatitis – puss caterpillar (larval stage of flannel
moth, 
Megalopyge opercularis) – hemorrhagic papulovesicles or
bullae 
Cutis 71:445–448, 2003
Clostridium perfringens/septicum Ann Emerg Med 10:312–314,
1981
Cowpox – papule progresses to vesicle to hemorrhagic vesicle
to umbilicated pustule, then eschar with ulcer 
JAAD 44:1–14,
2001; BJD 1331:598–607, 1994
Ecthyma gangrenosum
Pseudomonas
Enteric rods
Aeromonas hydrophila
Xanthomonas maltophila
Aspergillus species
Candida albicans
Capnocytophaga canimorsus
Enterobacter cloacae JAAD 27:637–638, 1992; Rev Infect Dis
44:13–28, 1982
Erysipelas, bullous
Flavobacterium odoratum – necrotizing fasciitis J Clin Inf Dis
21:1337–1338, 1995
Gonococcemia – periarticular lesions appear in crops with
red macules, papules, vesicles with red halo, pustules, bullae
becoming hemorrhagic and necrotic; suppurative arthritis and
tenosynovitis 
Ann Intern Med 102:229–243, 1985; NEJM
282:793–794, 1970
Herpes simplex
Herpes zoster 
Tyring p.133, 2002
Impetigo
Insect bite reaction 
Rook p.1425–1426, 1998, Sixth Edition;
mosquitoes 
The Clinical Management of Itching; Parthenon;
p.64, 2000
Klebsiella sepsis
Leprosy – erythema nodosum leprosum 
AD 132:1432–1434,
1996; nerve involvement – plantar hemorrhagic bulla Rook
p.1228, 1998, Sixth Edition
Lyme disease 
NEJM 321:586–596, 1989; AD 120:1017–1021,
1984
Meningococcemia – acute or chronic (petechial); acute; initially
ecchymoses, purpuric papules and plaques with surrounding
erythema, vesicles, bullae, hemorrhagic necrosis, purpura
fulminans 
Textbook of Neonatal Dermatology, p.195, 2001
Morganella morganii JAAD 12:575–576, 1985
Mosquito bite hypersensitivity syndrome in Epstein–Barr
virus-associated natural killer cell leukemia/lymphoma – clear or
hemorrhagic bullae with necrosis, ulceration and scar formation
JAAD 45:569–578, 2001
Necrotizing fasciitis 
AD 138:893–898, 2002
Nocardia asteroides AD 121:898, 1985
Orf 
AD 126:356–358, 1990; Isr J Med Sci 24:54–56, 1988
Papular purpuric gloves and socks syndrome 
J Dermatol
29:371–375, 2002
Pneumococcal cellulitis 
AD 132:81–86, 1996
Portuguese man of war
Proteus mirabilis
Pseudomonas sepsis
Purpura fulminans – variety of bacterial, fungal, and viral
organisms
Salmonella NY State J Med 81:1639–1641, 1981
Sea anemone sting
Smallpox
Snake bite
Spider bites – brown recluse spider bite 
Clin Inf Dis
32:595,636–637, 2001
Staphylococcal sepsis
Subacute bacterial endocarditis
Tropical ulcer (phagedenic ulcer) – mixed infection with
Fusobacterium ulcerans and other organisms; papule or bulla
(hemorrhagic) which breaks down to form ulcer with
undermined border 
Int J Dermatol 27:49–53, 1988
Typhoid fever
Varicella
Vibrio cholerae non-01 Clin Inf Dis 21:1330–1333, 1995
Vibrio vulnificus Clin Inf Dis 40:718,754–755, 2005;
AD 122:818–820, 1986

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