Diabetic bullae: 12 cases of a purportedly rare cutaneous disorder

Background Spontaneous bullae are a characteristic type of skin lesion occu rring in patients with diabetes mellitus. These diabetic bullae are conside red to be a rare phenomenon; only about 100 cases have been described in th e literature since the disorder was first reported 70 years ago. Methods We collected a series of patients with diabetic bullae who were ref erred to us at a Veterans Affairs Medical Center Clinic specializing in dia betic foot problems. We then reviewed the medical literature for similar ca ses and summarized the available information. Results We saw 12 patients with typical diabetic bullae over an 8-year peri od in our clinic. The clinical presentation and outcome of the lesions in t hese patients were similar to those in previously reported cases. The patie nts were mostly elderly, all but one had lesions located on the lower extre mities, all had peripheral neuropathy, two had secondary staphylococcal inf ection of their bullae, and in all patients the lesions healed without scar ring. Although most of the patients had had previous similar lesions, the d iagnosis of diabetic bullae had not been previously reported in any of them . Conclusions We have reviewed the clinical syndrome of diabetic bullae and p resented brief clinical details of these cases; we offer several vignettes and photographs of these lesions to remind clinicians of what we believe is a not so rare cutaneous disorder.