Blisters Flashcards
Define Vesicles, Bullae and pustules
fluid-filled lesions
Vesicles
-Fluid-filled lesion less than 5mm
Bullae
-Fluid-filled lesion greater than 5mm
Pustule- lesion containing purulent material (pus)
What is the aeitiology of blisters?
Trauma
-mechanical - shear
-thermal - hot/burn, cold/cryotherapy
-chemical - burns (Caustics/keratolytics therapies)
Non-traumatic
-infection
-immunological
-idiopathic
-genetic
What are some non-traumatic infections
Tinea pedis
impetigo
herpes simplex
name some non traumatic immunological aeitiolgies
allergic reaction to insect bite
-Pompholyx (type of eczema causes tiny blisters itchy)
-pemphigus (automimmune, blistering of the skin)
-pemphigoid
-epidermolysis bullosa
-Genetics kin blisters and tears with minimal touch. connective tissue disorder
Classification-
If stratum granulosum and corneum are involved, the blister is classified as
superfical
if the blister is visibly raised, painful and is at the spinosum layer
intra-epidermal
At sub-epidermal layer the blister has reached?
dermo-epidermal junction.
blister is firm and can be blood-filled
Treatment and management
What should we record in our notes
Location/size/ appearance ( base, margins surrounding skin), duration, discharge odour, presence of infection, pain, presence of foreign bodies
Action and Plan
List a few things you would take into account when thinking of treatment
establish cause and can this be addressed
should the blister be left intact, drained or de-roofed?
Offload pressure/reduce shear & friction forces
use of dressings
patient advice/health promotion
what are the positives of leaving a blister intact?
Acts as a natural barrer to infection
-cytokines /growth factors in blisters fluid may enhace healing
What is a negative of leaving a bister intact
Prolongs the inflammatory process, delaying wound healing
What is a positive of draining and de-roofing a blister?
Reduce the likelihood of wound progression by relieving pressure.
-provides the ability to assess the wound base
What is a negative of draining / de-roofing a blister
increases risk of infecton
When should a blister be left intact
if its not causing pain and there are no complications,
You have control of causative factors , ie, contributing shearing stress, footwear sport, patient activity
(consider antiseptic /protective dressing f appropriate)
When should drainage be considered?
If unable to successfully offload due to the high tension of the blister, meaning rupture is likely outside of controlled environment causing inevitable contamination
*infection is present
(blisters should ideally be left to dry out)
