A rare potentially fatal skin disease characterised by intra-epidermal bullae on apparently healthy skin or mucous membranes

Causes:

• Unknown (probably autoimmune)

Clinical features

• Occurs in middle-aged/older persons

- rare in children

• Tense or flaccid bullae of varying size

• Lesions may rupture leaving raw painful areas

• Bullae may be generalized or localized - commonly to the face

Differential diagnosis

• Chronic ulcerative facial lesions
• Other bullous dermatoses

Management

Clean affected area with chlorhexidine solution 0.05% or hydrogen peroxide solution 6%

HC2

Apply compresses soaked in potassium permanganate solution 0.01% every 4 hours

HC3

- helps remove skin debris and reduce risk of secondary infection

If there is secondary infection:

Give systemic antibiotic as for Boils, p175

If it persists or if severe:

Refer to a skin specialist