Differential Diagnosis > Morphology > Reaction Patterns > Vesicobullous > Superficial Blisters / Flaky Paint

Flaky Paint ddx

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This is a descriptive differential diagnosis where the varnishy scale resemble flaky paint (and often a superficial blister leaves a varnishy scale)

 

•asteototic eczema
•vitamin deficiency: glucagonoma syndrome (necrolytic migratory erythema), acrodermatitis enteropathica, pellagra, fatty acid deficiency
•superficial blister: pemphigus foliaceous, staph scalded skin/ bullous impetigo

 

extended ddx:

•ichthyosis linearis circumflexa distinct serpiginous arrangement with double edged scale, and usually in a child with Netherton's and the hair of trichorrhexis invaginata
•pellagra photodistributed
•less likely =  superficial pustule ddx – pustular psoriasis/ AGEP, SCPD, candida, bullous impetigo