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摘要

A 74-year-old woman presented to her primary care doctor for evaluation of two painless blisters on her right shin. Her medical history was significant for hypertension, hyperlipidemia, and type 2 diabetes with microalbuminuria. Her diabetes had been managed for more than 20 years and was currently controlled with oral medications (piogli-tazone, sitagliptin, and metformin) and long-acting insulin. She reported that the blisters spontaneously occurred on the preceding day with no history of trauma. She denied pain, pruritus, constitutional symptoms, and prior history of bullae. On exam, 2 tense 3 cm clear fluid-filled and 2 smaller bullae were present on her anterior right shin (Figure 1).