Decision tree analysis for the management of vesiculobullous lesions

Abstract

A mucocutaneous condition known as a vesiculobullous lesion is characterized by the presence of fluid-filled vesicles and bullae. Bullae and vesicles typically have different sizes. Bullae have a diameter greater than 5–10 mm, whereas vesicles have a diameter of less than 5–10 mm. Infectious etiologies such herpes simplex, varicella zoster infection, hand, foot, and mouth disease, herpangina, and measles can cause vesiculobullous lesions. Additionally, immunobullous conditions including pemphigus vulgaris, pemphigoid, dermatitis herpetiformis, linear IgA disease, or inherited conditions like epidermolysis bullosa may be to blame. The management of common vesiculobullous disorders is reviewed using a decision tree analysis based on etiopathogenesis, clinical characteristics, and diagnostic criteria. A decision tree has been formulated based on predominantly vesicular and predominantly bullous lesions with specific lesions in each category based on recent scientific evidence. This decision tree will guide the clinicians for effective management of the vesiculobullous lesions in the dental office. The timely recognition and management of these lesions is very essential as they can compromise the quality of life due to their chronicity and frequent recurrence in nature.