Bullous Eruption of Diabetes Mellitus:  A Case With Positive Immunofluorescence Microscopy Findings

Diabetes mellitus is a systemic disorder with cutaneous manifestations that need not correlate with gross derangements of intermediary metabolism. The lesions may be bullous, necrobiotic, or atrophic and hyperpigmented, as in diabetic dermopathy.¹ In a recent study of a patient with the bullous eruption of diabetes mellitus,² findings from both direct and indirect immunofluorescence microscopy examinations of the skin were negative.

We have found positive direct perivascular immunofluorescence in involved tissue from a patient with the bullous eruption of diabetes mellitus.

Report of a Case  A 73-year-old woman had a two-year history of adult-onset diabetes mellitus that was controlled with 25 units/day of isophane insulin suspension. Complicating her disease were peripheral neuropathy and diabetic retinopathy. She had no other medical problems and was taking no additional medication. One month before examination, an asymptomatic bullous eruption had developed, which had first manifested as a 2 × 2-cm bulla on