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The vesicobullous reaction pattern includes those diseases that present with vesicles and bullae. These are both colloquially referred to as blisters. In this chapter, this term is used to imply a combination of vesicles and bullae. The vesicobullous reaction pattern overlaps with the eczematous reaction pattern, in that vesicles and bullae are seen in acute eczema. So, it would be accurate to categorize acute eczema as either eczematous or vesicobullous reaction pattern.

Clinical Tip

Vesicobullous and eczematous reaction patterns overlap; acute eczema, such as an allergic contact dermatitis due to poison ivy, also fits into the vesicobullous reaction pattern.

Some blistering diseases may have a papulosquamous presentation, as has been mentioned previously. Pemphigus foliaceus is a classic example of this. It frequently presents with exfoliative plaques and very few or indistinct erosions. Other blistering diseases, such as pemphigus vegetans, present as vegetating plaques.

Clinical Tip

A vesicobullous reaction pattern may have a papulosquamous presentation.

As with papulosquamous disease, it is useful when encountering a patient with vesicobullous disease to have a ready-made differential diagnostic list to be able to apply to the presenting dermatosis. Table 7.1 contains such a list for the vesicobullous reaction pattern, subdivided by the etiologic classification. Again, this list is comprehensive, but by no means complete. A description of the classic presentation of each disease follows:

TABLE 7.1.Vesicobullous Diseases by Etiologic Classification

All inherited blistering diseases ...

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