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Bullosis Diabeticorum — SCE Dermatology MCQ

Instant feedback + full explanation. One question, done properly.

HardBlistering DiseasesBullosis DiabeticorumSCE Dermatology

A patient with long-standing diabetes develops a painless tense 4-cm bulla overnight on non-inflamed dorsal foot skin. It contains clear fluid and there are no systemic features. What is the best immediate management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Protect the intact blister, address foot risk and monitor for secondary infection

Explanation lettering: B = shown as A · C = shown as B · E = shown as C · A = shown as E

A is correct. Bullosis diabeticorum produces spontaneous non-inflammatory acral bullae, often in people with neuropathy or microvascular complications. The roof is usually left intact as a biological dressing, protected with sterile care and monitored closely; aspiration may be considered while preserving the roof when size or tension creates risk. Antibiotics require evidence of secondary infection, not diabetes alone. Foot perfusion, sensation, pressure risk and glycaemic control should be reviewed. Atypical recurrence, inflammation or diagnostic uncertainty warrants biopsy and immunofluorescence to exclude autoimmune blistering disease.

Reference: British Journal of Diabetes: diabetic bullae: https://www.bjd-abcd.com/bjdvd/index.php/bjd/article/view/52