Bil 1st MPJ blisters with unclear diagnosis

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I am treating an elderly male patient (70's) mostly bedbound or chairbound. Has localised blister on plantar aspect both 1st mpj. There is no apparent cause. Clear fluid filled blister started last week as a vesicle and erupted into large blister with surrounding localised erythema. Medical history of MS. Unsure of diagnosis ???? Differentially diagnosed bullous pemphigoid? Has anyone come across this condition before, or any ideas on a differential diagnosis? Much appreiated

 

Hi there, I am unexperienced with dermatological presentations however Some things come to mind...

1) Are there any other lesions apparent elsewere?
2) Has he been tested for allergies?
3) Hosiery? bedsheets?

If the blisters are only on feet it seems unlikely that it is a systemic blistering condition such as erythematous bullosa as they often present widespread??

I would be glad to hear your thoughts and further findings you may have. Good Luck

Kirsty

 

What is his general health like, heart complaint, diabetes, kidney problems, medication, co-morbidities ????? oh, and a photo )

 

:empathy:What is his general health like, heart complaint, diabetes, kidney problems, medication, co-morbidities ????? oh, and a photo )

 

Why not consider something simple. Is he wearing cotton socks? Probably. When cotton socks are worn, they get wet. Feet sweat. A lot. Cotton stretches, doesn't move with the foot, causing shearing. Causing blisters.