Painful, recurrent, bleeding ulcers

Presenter:  unknown
Dermatology Program: Botsford/McLaren/MSU
Program Director: Annette LaCasse, DO
Submitted on: Apr 12, 2015

CHIEF COMPLAINT:  An 18 year-old female with history of acne and eczema presented with a many-year history of painful, recurrent, bleeding ulcers on her bilateral feet.

CLINICAL HISTORY:

Signs and symptoms:  She stated that she gets blister-like lesions on especially when on her feet a lot during sports seasons.

Previous Treatment:  She had never received treatment for the lesions.

Other information:  Review of systems was negative for any malaise, recent illness, shortness of breath, fatigue, weight loss, or weight gain, and positive for hyperhidrosis of the feet. She was otherwise healthy.

PHYSICAL EXAM:

Physical examination of the hands and feet revealed normal hands and bilateral bullae on the right and left planter surfaces, along sites of lateral or rotatory traction.

Hemorrhagic bullae

LABORATORY TESTS:

As diagnosis was made clinically based upon concordant history and physical exam, no labs or imaging were preformed.

DERMATOHISTOPATHOLOGY:

None

DIFFERENTIAL DIAGNOSIS:

1.   Epidermolysis Bullosa Simplex: Localized (Weber-Cockayne)
2.   Friction Bullae


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