Book contents
- Frontmatter
- Contents
- Preface
- Acknowledgments
- Prologue
- Introduction
- 1 The Case of Black Sweat
- 2 A Case of Hives That Wouldn't Go Away
- 3 The Painful Bath
- 4 A Shower of Hives
- 5 A Premenstrual Rash
- 6 Uncombable Hair
- 7 The Man Who Couldn't Sweat
- 8 Scratch Blisters
- 9 Skin Deep Photography
- 10 The Bug That Never Was
- 11 Blue Spots
- 12 White Spots
- 13 Same Place, Next Time Rash
- 14 The Brown Spots That Wouldn't Go Away
- 15 The Case of the Painful Fingertips
- 16 A Strange Sunburn
- 17 A Multiple Personality Dermatitis
- 18 Accidental Hives
- 19 Rotten Fish Odor
- 20 Hormone Blisters
- 21 Flower Shop Itch
- 22 “Stress and a Penny” Hives
- 23 The Case of Unilateral Wrinkles
- 24 Fiery Red Legs
- 25 Painful Feet
- 26 Hot Flashes and Cold Cream
- 27 The Blisters and the Skin Test
- 28 A Chilling Pain
- 29 Rough Skin and Sore Throats
- 30 The Premenstrual Purple Chin
- 31 Nine Year Hives
- 32 Golf Course Dermatitis
- 33 The Secret Message
- 34 Herpes Gladiatorum
- 35 Sunshine Allergy
- 36 L'homme Rouge
- 37 Rings of Rash
- 38 The Breasts That Never Stopped Growing
- 39 The Minister's Hives
- 40 Hardened Skin
- 41 Battery Blisters
- 42 Swollen Lips
- 43 The Worm from Outer Space
- 44 A New Light on Psoriasis
- 45 Black and Blue Spots
- 46 The Emergency Room Itch
- 47 The Sleeper
- 48 A Crazy Rash
- 49 Bald Spots
- 50 The Dog Died
- 51 The Abacus Tumor
- 52 No Spit
- 53 The Smell of Burnt Toast
- 54 The Twenty-Three Year Itch
- 55 The Mysterious Treatment
- 56 The Creeping Acne Cyst
- 57 Our First Case
- 58 A Strange Case of Acne
- 59 The Case of the Glass Eye
- 60 The Hand Eczema Caper
- 61 The Sore That Would Never Heal
- 62 Black Blisters
- References
- Index
41 - Battery Blisters
Published online by Cambridge University Press: 23 November 2009
- Frontmatter
- Contents
- Preface
- Acknowledgments
- Prologue
- Introduction
- 1 The Case of Black Sweat
- 2 A Case of Hives That Wouldn't Go Away
- 3 The Painful Bath
- 4 A Shower of Hives
- 5 A Premenstrual Rash
- 6 Uncombable Hair
- 7 The Man Who Couldn't Sweat
- 8 Scratch Blisters
- 9 Skin Deep Photography
- 10 The Bug That Never Was
- 11 Blue Spots
- 12 White Spots
- 13 Same Place, Next Time Rash
- 14 The Brown Spots That Wouldn't Go Away
- 15 The Case of the Painful Fingertips
- 16 A Strange Sunburn
- 17 A Multiple Personality Dermatitis
- 18 Accidental Hives
- 19 Rotten Fish Odor
- 20 Hormone Blisters
- 21 Flower Shop Itch
- 22 “Stress and a Penny” Hives
- 23 The Case of Unilateral Wrinkles
- 24 Fiery Red Legs
- 25 Painful Feet
- 26 Hot Flashes and Cold Cream
- 27 The Blisters and the Skin Test
- 28 A Chilling Pain
- 29 Rough Skin and Sore Throats
- 30 The Premenstrual Purple Chin
- 31 Nine Year Hives
- 32 Golf Course Dermatitis
- 33 The Secret Message
- 34 Herpes Gladiatorum
- 35 Sunshine Allergy
- 36 L'homme Rouge
- 37 Rings of Rash
- 38 The Breasts That Never Stopped Growing
- 39 The Minister's Hives
- 40 Hardened Skin
- 41 Battery Blisters
- 42 Swollen Lips
- 43 The Worm from Outer Space
- 44 A New Light on Psoriasis
- 45 Black and Blue Spots
- 46 The Emergency Room Itch
- 47 The Sleeper
- 48 A Crazy Rash
- 49 Bald Spots
- 50 The Dog Died
- 51 The Abacus Tumor
- 52 No Spit
- 53 The Smell of Burnt Toast
- 54 The Twenty-Three Year Itch
- 55 The Mysterious Treatment
- 56 The Creeping Acne Cyst
- 57 Our First Case
- 58 A Strange Case of Acne
- 59 The Case of the Glass Eye
- 60 The Hand Eczema Caper
- 61 The Sore That Would Never Heal
- 62 Black Blisters
- References
- Index
Summary
“It all began with blisters behind my ears five months ago,” a sixty-nine-year-old woman told us on her first visit. It would be many visits later before we could find the cause.
She described the blisters as initially being small and very itchy. As the months went by, new blisters appeared on her face, chest and, most dramatically, over her left thigh. She had always been in good health with no prior skin disease. But two years ago she had fractured her left hip. This required extensive orthopedic care, involving screws, bone grafting with a buttress plate, and the implant of an osteogenic bone growth stimulator.
On examination the blisters were large, tense, and filled with a clear fluid, while the surrounding skin was red and slightly elevated. Rubbing the skin firmly did not produce any new blisters. This simple sign (Nikolsky) helped rule out the grave diagnosis of pemphigus.
Clinically, her problem appeared to be the blistering eruption called “bullous pemphigoid,” usually seen in older individuals. However, skin biopsies did not confirm this diagnosis, showing only that the epidermis was lifted off of the dermis by the blister fluid. Extensive blood studies told us that she had a very high serum level of the immune protein, IgE, seen in allergic individuals.
We were able to suppress the blisters with intramuscular cortisone shots and an oral antibiotic, but the problem was not really solved.
- Type
- Chapter
- Information
- Consultations in DermatologyStudies of Orphan and Unique Patients, pp. 126 - 128Publisher: Cambridge University PressPrint publication year: 2006