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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 AND/OR VESICLES
93
Schneiderman page 1-100.qxd 5/16/2006 6:49 PM Page 93


Mycoplasma pneumoniae – varicella-like rash Am J Dis Child
128:254–256, 1974
Necrotizing fasciitis – necrotic bullae; streptococcal 
Curr Prob
in Dermatol 14:183–220, 2002; Ann DV 128:376–381, 2001;
Serratia marcescens Clin Inf Dis 23:648–649, 1996; JAAD
20:774–778, 1989; Bacteroides spp.in penile necrotizing fasciitis
JAAD 37:1–24, 1997; neonatal Pediatrics 103:e53, 1999; in
infancy 
Ped Derm 2:55–63, 1984; Clostridial cellulitis
(gangrene); progressive synergistic gangrene; gangrenous
cellulitis (
Pseudomonas); Fournier’s gangrene Rook p.1164,
1998, Sixth Edition
Nocardia asteroides AD 121:898–890, 1985
Non-clostridial crepitant cellulitis
Non-clostridial myositis
Omsk hemorrhagic fever virus – infected muskrats in western
Siberia; papulovesicular lesions of soft palate 
AD 140:656, 2004
Orf – vesicopapule 
JAAD 44:1–14, 2001; generalized bullous orf
Int J Derm 6:340–341, 1980; AD 126:356–358, 1990
Otitis externa 
Ann Otol Rhinol Laryngol 82 (Suppl 8):1–23, 1973
Paecilomyces lilacinus – vesicular lesions JAAD 39:401–409,
1998; papulovesicular lesions Ann Intern Med 125:799–806,
1996
Papular urticaria
Pediculid, bullous 
Cutis 41:281, 1988
Pediculosis – pubic lice (
Phthirus pubis) Arch Dermatol Syphilol
65:334–339, 1952
Phaeohyphomycosis – 
JAAD 40:364–366, 1999
Phycomycotic gangrenous cellulitis
Portuguese man-of-war stings – vesicular 
J Emerg Med
10:71–77, 1992
Progressive bacterial synergistic gangrene – postoperative
(Meleney’s synergistic gangrene) 
Protothecosis – vesiculobullous lesions 
Med 64:115–133, 1985;
JAAD 32:758–764, 1995
Pseudomonas sepsis – bullae which rupture to yield necrotic
ulcers (ecthyma gangrenosum) 
Medicine 64:115–133, 1985;
Ped Derm 4:18–20, 1987
Puss caterpillar – purpuric papulovesicles 
Cutis 60:125–126,
1997
Q fever – 
Coxiella burnetii ; vesicles JAAD 49:363–392, 2003
Rat bite fever (
Streptobacillus moniliformis (pleomorphic
facultative anaerobic bacillus) or 
Spirillium minor (Soduku)) –
macular, petechial, or morbilliform widespread exanthem;
palmoplantar rash; arthralgia and chronic arthritis; Haverhill
fever (raw milk) – papules, crusted papules, vesicles, pustules;
chronic abscesses
Cleveland Clin Q 52 (2):203–205, 1985;
Pediatr Clin N Am 26:377–411, 1979
Rickettsia australis; R. conorii – varicelliform rash –
papulovesicular
Ricketsial pox (
Rickettsia akari ) (house mouse mite bite) –
generalized papules, vesicles, papulovesicles, crusts
NEJM 331:1612–1617, 1994; Clin Inf Dis 18:624–626, 1994
Rickettsia australis (tick typhus) – papulovesicular Clin Inf Dis
18:118–119, 1994
Roseola infantum (human herpesvirus 6) – rose-pink macules
start on neck and trunk, then spread to face and extremities;
rarely vesicular 
BJD 132:614–616, 1995; Rook p.998,1025,
1998, Sixth Edition
Salmonella – vesicular eruptions Rook p.1143, 1998,
Sixth Edition; NYSJMed 81:1639–1641, 1981
Scabies with bullous pemphigoid-like eruption 
JAAD
20:878–879, 1996; JAAD 24:179–181, 1991; vesicles and
bullae 
JAAD 20:134–136, 1989; palmar bullae JAAD
49:346–350, 2003; palmar and plantar bullae in infancy Ped
Derm 15:108–111, 1998; JAMA 230:878, 1974
Sealpox (parapoxvirus) – gray concentric nodule with
superimposed bulla on dorsum of hand 
BJD 152:791–793,
2005
Serratia marcescens
Smallpox – varicella-like 
JAAD 44:1–14, 2001; smallpox
vaccination site
Snake bites – edema, erythema, pain, bullae, ecchymosis and
necrosis 
NEJM 347:347–356, 2002
Spider bites 
Trans R Soc Trop Med Hyg 92:546–548, 1998;
South Med J 69:887–891, 1976; brown recluse spider bite
JAAD 44:561–573, 2001
Staphylococcal scalded skin syndrome – toxic epidermal
necrolysis;
Zentralseit Kinderheilkd 2:3–23, 1878
Staphylococcal sepsis
Straw itch mites – varicella-like 
JAMA 247:1821, 1982
Streptococcus, Group B – resembles bullous impetigo Textbook
of Neonatal Dermatology, p.189, 2001
Streptococcal gangrene (necrotizing fasciitis) 
JAAD
20:774–778, 1989
Group G streptococcal myositis with toxic shock syndrome
Clin Inf Dis 23:1159–1161, 1996
Streptococcal toxic shock syndrome – painful localized edema
and erythema; progression to vesicles and bullae 
Textbook
of Neonatal Dermatology, p.189, 2001
Syphilis, congenital; vesicular Jarisch–Herxheimer reaction
AD 125:77–81, 1989; papulovesicular lesions in AIDS JAAD
22:1061–1067, 1990
Tick bite – soft ticks; Argasid ticks 
Lancet ii:288–289,1982;
Ornithodorus 
JAAD 49:363–392, 2003
Tinea corporis, pedis – bullous 
Rook p.1300–1301,1309, 1998,
Sixth Edition
Toxic shock syndrome, either streptococcal or staphylococcal –
widespread macular erythema, scarlatiniform, and
papulopustular eruptions; occasional vesicles and bullae;
edema of hands and feet; mucosal erythema; second week
morbilliform or urticarial eruption occurs with desquamation
at 10–21 days 
JAAD 39:383–398, 1998; Rev Infect Dis 11
(Suppl 1):S1–7, 1989; JAAD 8:343–347, 1983
Toxoplasmosis 
Rook p.1422, 1998, Sixth Edition
Trichosporon beigelii AD 129:1020–1023, 1993
Tropical ulcer (phagedenic ulcer) – mixed infection with
Fusobacterium ulcerans and other organisms; papule or
bulla which breaks down to form ulcer with undermined border
Int J Dermatol 27:49–53, 1988
Tularemia – vesiculopapular lesions of trunk and extremities
Photodermatology 2:122–123, 1985
Vaccinia – Jennerian vesicle; papulovesiculopustule 
JAAD
44:1–14, 2001; progressive vaccinia – cellulitis with bullae
J Clin Inf Dis 25:911–914, 1997
Varicella – vesicular 
Tyring p.3,121–122, 2002; Rook
p.1017–1018, 1998, Sixth Edition; bullous JAAD 9:209–212,
1983; oral vesicles Rook p.3057, 1998, Sixth Edition
Variola – papulovesiculopustule 
Tyring p.3,42, 2002;
Rook p.998, 1998, Sixth Edition
Verruca vulgaris with secondary infection
Vesicular stomatitis virus – vesicles of fingers, gums, buccal,
and pharyngeal mucosa 
NEJM 277:989–994, 1967
Vibrio vulnificus Clin Inf Dis 40:754–755, 2005
Yersinia enterocolitica – vesicles J Clin Inf Dis 21:223–224, 1995
Yersinia pestis (plague) – umbilicated vesicles or pustules
J Infect Dis 129:S78–84, 1974

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