By Gary M. White, MD
Bullous tinea is a fungal infection of the ski, typical by a dermatophyte, that causes bulla. The bulla form as a resulte of the intense inflammatory reaction of the body to a fungal organism. The causative dermatophyte is often Trichophyton mentagrophytes.
Grouped vesicle and bulla on the soles are typical. Adjacent red, scaly areas more typical of tinea pedis may be seen. Bullous tinea cruris [J Cutan Med Surg. 2013 Jul-Aug;17(4):224-5.] and tinea corporis [Eur J Dermatol. 2012 Nov-Dec;22(6):805-6] have been reported. Some cases have had positive direct immunofluorescence [Am J Dermatopathol. 2013 Jul;35(5):587-94].
For other causes of bulla on the soles, consider pompholyx, friction blisters, and if lifelong, the Weber-Cockayne variant of epidermolysis bullosa simplex.
A topical antifungal agent will usually suffice but in severe cases, an oral agent is needed. See tinea pedis for treatment suggestions. The bulla may be drained if large.
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