From the Guidelines
Vesicles are small, fluid-filled blisters on the skin that measure less than 5-10 millimeters in diameter, containing serous fluid that develops when fluid becomes trapped between layers of skin, as noted in a study published in 2021 1. They appear as raised, clear or translucent bubbles. Common causes of vesicles include viral infections like herpes simplex, varicella-zoster (chickenpox/shingles), contact dermatitis, allergic reactions, friction, burns, or autoimmune conditions such as dermatitis herpetiformis or bullous pemphigoid. Some key points about vesicles include:
- They form when inflammation or injury causes separation between skin cells, allowing fluid to accumulate in the space, as seen in cases of cellulitis and erysipelas 1.
- These lesions may be itchy, painful, or asymptomatic depending on the underlying cause.
- If vesicles rupture, they may form crusts or scales.
- Treatment depends on identifying and addressing the underlying cause, which might include antiviral medications for herpes infections, topical corticosteroids for dermatitis, or avoidance of allergens, as recommended in a guideline update from 2014 1.
- It's essential to avoid scratching or rupturing vesicles as this can lead to secondary bacterial infections and scarring, highlighting the importance of proper wound care, as discussed in a study from 2021 1. In terms of management, a study from 2021 1 suggests that for blisters less than 10% of the body surface area, asymptomatic and noninflammatory, cessation of immune checkpoint inhibitor therapy is not necessary, and only observation or local wound care is warranted. However, for symptomatic bullae or erosions, which are deroofed vesicles or bullae, the cutaneous irAE is considered at least grade 2, and treatment with high-potency topical steroids and possibly systemic steroids may be necessary, as outlined in the 2021 study 1.
From the Research
Definition of Vesicles
- Vesicles refer to small, fluid-filled sacs or blisters that can appear on the skin as a type of lesion.
- In the context of skin lesions, vesicles are often associated with various skin conditions, such as hidradenitis suppurativa, which is characterized by the formation of painful abscesses and vesicles in the apocrine-gland-bearing areas of the body 2.
- Vesicles can also be related to extracellular vesicles, which are small membrane-bound particles that can be released by cells and play a role in cell-to-cell communication and the transfer of molecules between cells 3, 4.
Characteristics of Vesicles
- Vesicles can be filled with a clear fluid, such as serum or pus, and can appear as small, raised bumps on the skin.
- They can be caused by a variety of factors, including infections, allergic reactions, and skin conditions such as eczema or dermatitis.
- In some cases, vesicles can be a symptom of an underlying condition, such as a bacterial or fungal infection, and may require treatment with antibiotics or other medications 5, 6.
Treatment of Vesicles
- The treatment of vesicles depends on the underlying cause and can include medications such as antibiotics or antifungals, as well as topical treatments such as creams or ointments.
- In some cases, vesicles may need to be drained or lanced to relieve pressure and promote healing.
- It is essential to consult a healthcare professional for proper diagnosis and treatment of vesicles, as they can be a symptom of a more serious underlying condition 2.