Bullosis diabeticorum is a sudden blistering of the skin unique to patients with diabetes. It usually affects people between the ages of 17-84, and men are twice as likely as women to suffer from it. The cause of the disease is unknown. These lesions usually appear on the feet and toes, but occasionally on the hands and fingers. They are usually 0.5 to several centimetres in size, and contain a clear, sterile, viscous fluid.
There are two kinds of lesions. Intra-epidermal bullae are clear, sterile, non-haemorrhagic blisters that generally heal on their own within 2-5 weeks without scarring or atrophy. This type of bullae is more common in men with good circulation to the involved extremity (Bolognia and Braverman, 1998). Sub-epidermal bullae are the least common of the two types of bullosis diabeticorum (Huntley, 1982). These blisters are similar to the intra-epidermal blisters except they are occasionally subject to hemorrhage, and may heal with scarring and atrophy.
Bullosis diabeticorum is usually self-limiting; however, bacterial infections can result in deep infections (Huntley, 1982). Many, but not all, patients with this condition have nephropathy (any kidney disease) or neuropathy (any disease of the nervous system.) Bullosis diabeticorum tends to occur in patients with long-standing diabetes mellitus or with multiple complications of the disease. It has been reported to occur in approximately 0.5% of people with diabetes. Patients with uncomplicated or newly diagnosed diabetes also may be affected. Blisters may recur; lesions tend to heal without significant scarring. No significant morbidity is associated with this condition unless secondary infection occurs. One report has described inflammation of the bone and bone marrow arising at a site of bullosis diabeticorum. Local care to avoid blister eruption and appropriate antibiotic treatment for secondary infection is recommended.
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My diabetes is changing. Until a few years ago, my morning readings were reasonable and within the desired range of under 100 mg/dl. About two years ago, they started slipping upwards into the less-desirable but apparently not-worrisome range of 100-110 mg/dl. Now, this was what was recorded by my Abbott Freestyle Lite meter, which is known to record at the lower end of the home-glucometer variability range, but with my A1c firmly in the high 5s and low 6s, the meter's tendency to...