Some electron microscopic evidence has suggested an abnormality in anchoring fibrils. A reduced threshold to suction-induced blister formation has been reported. Prominent acral accentuation of these lesions suggests a susceptibility to trauma-induced changes, but the definitive explanation awaits elucidation. No significant morbidity is associated with this condition unless secondary infection occurs. The reported age of onset ranges from 17-84 years.
Blisters occur spontaneously and abruptly, usually without known antecedent trauma.
Lesions tend to be asymptomatic, although mild discomfort or burning has been described. Blisters heal spontaneously within 2-6 weeks of onset. Bullosis diabeticorum presents as tense blisters arising on nonerythematous skin. Elevated levels may indicate porphyria cutanea tarda. Levels reportedly are normal in bullosis diabeticorum.