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Pod practice > Vesicles, Bullae and Blisters > Flashcards

Vesicles, Bullae and Blisters Flashcards

1
Q

What is a blister?

A
  • A fluid filled lesion
  • Described as either a vesicle or bullae (depending on size)
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2
Q

What is a pustule?

A

A lesion filled with purulent material (pus) rather than fluid

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3
Q

What are the characteristics of a Vesicle?

A
  • <5mm
  • Fluid filled
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4
Q

What are the characteristics of a Bullae?

A
  • >5mm
  • Fluid filled
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5
Q

What types of trauma are aetiologies for blister?

A
  • Mechanical
  • Thermal
  • Chemical
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6
Q

What types of non-traumatic causes are aetiologies for blisters?

A
  • Infection
  • Immunological
  • Idiopathic (unknown)
  • Genetic
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7
Q

What types of common infections can cause blistering?

A
  • Tinea Pedis
  • Impetigo (bacterial infection caused by S.Aureus
  • Herpes Simplex
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8
Q

What non-traumatic immunological responses can cause blistering?

A
  • Allergic reaction to insect bite
  • Pompholyx
  • Pemphigus
  • Pemphigoid
  • Epidermolysis bullosa
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9
Q

What are clinical presentations of Pompholyx?

A
  • Bubble
  • Tiny clear blisters which can cover a large area
  • Appear on hands and feet
  • Usually itchy
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10
Q

What is Epidermolysis Bullosa?

A
  • A group of connective tissue disorders
  • Genetic
  • Various types - Simplex, dystrophic, and junctional
  • Skin can blister and tear with minimal touch
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11
Q

What type of mechanical trauma would cause blistering?

A
  • Shear stress
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12
Q

What is superficial blistering?

A
  • Blister occurs in s.corneum/granulosum layer
  • Superficial acute shearing stress causes breakdown of S.corneum layer
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13
Q

What is intra-epidermal blistering?

A
  • Involves lower layers of epidermis - s.spinosum
  • Result of ongoing shearing stress
  • s.spinosum has broken down due to stress
  • Painful due to fluid filled serum sac pressurising nerve endings
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14
Q

What are sub-epidermal blisters?

A
  • Occurs at dermal-epidermal junction
  • Result of excessive and deeper shearing stress
  • Epidermis seperates from dermis to form a firmer, raised blister
  • Tissue disruption is can be accompanied by a bleed into the serum sac to form a blood blister
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15
Q

What needs to be commented on when recording lesions?

A
  • Location
  • Size
  • Duration
  • Presence of infection?
  • Pain
  • Discharge
  • Appearance
  • Odour
  • Presence of foreign bodies
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16
Q

What is the Action and Plan part of treating blisters?

A
  • Establish cause
  • Should blister be left intact, drained, or de-roofed?
  • Offload pressure to reduce shear stress
  • Use of dressings
  • Patient advice / health promotion
17
Q

What are the positives and negatives to leaving a blister intact?

A
  • Positives
    • Acts as a natural barrier to infection
    • Cytokines / growth factors in blister fluid may help healing process
  • Negatives
    • Prolongues inflammatory stage of wound healing
18
Q

What are the positives and negatives to de-roofing blisters?

A
  • Positives
    • reduces likelihood of wound progression by relieving pressure.
    • Provides ability to access wound base
  • Negatives
    • Increases risk of infection
19
Q

When should blsiters be left intact?

A
  • If they are not causing any pain and there are no further complications
20
Q

When should blisters be drained?

A
  • If you are unable to offload pressure due to the high tension of the blister, meaning rupture would be likelihood anyway outside of hygenic environment
  • If infection is present
21
Q

What is the procedure to drain a blister?

A
  • Irrigate the area (clean with saline solution)
  • Use forceps and gauze found in sterile pack
  • Disregard gauze and forceps
  • Dry area with new forceps and gauze
  • Make incision at top and base of blister (blade 15)
  • Soak up exudate with sterile gauze
  • Cleanse area
  • Have area checked
  • Dress & Pad
22
Q

What common dressings can be used for blisters?

A
  • Melolin
  • Inadine
  • Duoderm

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