Vesicular skin lesions

Causes

Appropriate Tests

 

Vesicle fluid for microscopy and bacterial culture, virus culture, detection (NAA), if infection is a suspected cause.
Scraping of vesicle base for virus culture, detection.

Biopsy may be indicated.

Viral infections, especially

  • Herpes simplex
  • Varicella zoster
  • Hand, foot and mouth disease
  • Molluscum contagiosum

 

Clinical diagnosis, testing not required.

Bacterial infection, especially

  • Streptococcus pyogenes
  • Clostridium perfringens

Vesicles are usually a skin manifestation of severe underlying sepsis with septicaemia. Blood culture.

Eczema

 

Trauma, especially

  • Burns
  • Chemical damage

 

Adverse/fixed drug reactions, especially

  • Tetracycline
  • Cotrimoxazole
  • Topical applications

 

Dermatitis herpetiformis

See under Coeliac disease

Porphyria