Summary: Visible accumulations of fluid within or beneath the epidermis.

Top Publications

  1. Ludwig R, Recke A, Bieber K, Müller S, Marques A, Banczyk D, et al. Generation of antibodies of distinct subclasses and specificity is linked to H2s in an active mouse model of epidermolysis bullosa acquisita. J Invest Dermatol. 2011;131:167-76 pubmed publisher
    ..Furthermore, our data are the basis for future studies with the goal of identifying non-MHC EBA susceptibility genes. ..
  2. Groves R, Liu L, Dopping Hepenstal P, Markus H, Lovell P, Ozoemena L, et al. A homozygous nonsense mutation within the dystonin gene coding for the coiled-coil domain of the epithelial isoform of BPAG1 underlies a new subtype of autosomal recessive epidermolysis bullosa simplex. J Invest Dermatol. 2010;130:1551-7 pubmed publisher
    ..With regard to skin blistering, the clinicopathological findings expand the molecular basis of EB by identifying BPAG1-e pathology in a new form of autosomal recessive EB simplex...
  3. Has C, Castiglia D, Del Rio M, Diez M, Piccinni E, Kiritsi D, et al. Kindler syndrome: extension of FERMT1 mutational spectrum and natural history. Hum Mutat. 2011;32:1204-12 pubmed publisher
    ..Environmental factors and yet unidentified modifiers may play a role. Better understanding of the molecular pathogenesis of KS should enable the development of prevention strategies for disease complications. ..
  4. Gil M, Modol T, España A, López Zabalza M. Inhibition of FAK prevents blister formation in the neonatal mouse model of pemphigus vulgaris. Exp Dermatol. 2012;21:254-9 pubmed publisher
    ..In conclusion, our data reveal a novel role of phosphorylated FAK (Y397/925) in PV development involving HER isoforms, Src and mTOR kinases. ..
  5. Spindler V, Endlich A, Hartlieb E, Vielmuth F, Schmidt E, Waschke J. The extent of desmoglein 3 depletion in pemphigus vulgaris is dependent on Ca(2+)-induced differentiation: a role in suprabasal epidermal skin splitting?. Am J Pathol. 2011;179:1905-16 pubmed publisher
    ..Moreover, protein kinase C inhibition blocked suprabasal Dsg3 depletion in cultured human epidermis and blister formation in a neonatal mouse model...
  6. Klink T, Kann G, Ellinger P, Klink J, Grehn F, Guthoff R. The prognostic value of the wuerzburg bleb classification score for the outcome of trabeculectomy. Ophthalmologica. 2011;225:55-60 pubmed publisher
    ..However, the study could not reveal a certain prognostic value of the early total bleb score using the WBCS for the long-term complete success of trabeculectomy. ..
  7. Tsunoda K, Ota T, Saito M, Hata T, Shimizu A, Ishiko A, et al. Pathogenic relevance of IgG and IgM antibodies against desmoglein 3 in blister formation in pemphigus vulgaris. Am J Pathol. 2011;179:795-806 pubmed publisher
    ..a pathogenic mAb against Dsg3, AK23 IgG, which induces a pemphigus vulgaris-like phenotype characterized by blister formation...
  8. Guthoff R, Guthoff T, Hensler D, Grehn F, Klink T. Bleb needling in encapsulated filtering blebs: evaluation by optical coherence tomography. Ophthalmologica. 2010;224:204-8 pubmed publisher
    ..A collapsed cyst at day 2 after needling is an indicator of controlled intraocular pressure, whereas a prominent cyst after 6 months indicates poor function. ..
  9. Saito M, Stahley S, Caughman C, Mao X, Tucker D, Payne A, et al. Signaling dependent and independent mechanisms in pemphigus vulgaris blister formation. PLoS ONE. 2012;7:e50696 pubmed publisher
    ..These findings have important implications for understanding pemphigus pathophysiology, and for the design of pemphigus model systems and therapeutic interventions. ..

More Information


  1. Qu H, Wen T, Pesch M, Aumailley M. Partial loss of epithelial phenotype in kindlin-1-deficient keratinocytes. Am J Pathol. 2012;180:1581-92 pubmed publisher
    ..Moreover, the constellation of molecular defects associated with the loss of kindlin-1 may explain the higher incidence of skin cancer observed in patients affected with this disorder. ..
  2. Oswald E, Sesarman A, Franzke C, Wölfle U, Bruckner Tuderman L, Jakob T, et al. The flavonoid luteolin inhibits Fc?-dependent respiratory burst in granulocytes, but not skin blistering in a new model of pemphigoid in adult mice. PLoS ONE. 2012;7:e31066 pubmed publisher
    ..These studies establish a robust animal model that will be a useful tool for dissecting the mechanisms of blister formation and will facilitate the development of more effective therapeutic strategies for managing pemphigoid ..
  3. Sitaru A, Sesarman A, Mihai S, Chiriac M, Zillikens D, Hultman P, et al. T cells are required for the production of blister-inducing autoantibodies in experimental epidermolysis bullosa acquisita. J Immunol. 2010;184:1596-603 pubmed publisher
    ..Although mechanisms of autoantibody-induced blister formation were extensively characterized, the initiation of autoantibody production in autoimmune blistering ..
  4. de Araujo E, Dessirier V, Lapree G, Valeyrie Allanore L, Ortonne N, Stathopoulos E, et al. Death ligand TRAIL, secreted by CD1a+ and CD14+ cells in blister fluids, is involved in killing keratinocytes in toxic epidermal necrolysis. Exp Dermatol. 2011;20:107-12 pubmed publisher
    ..Previous studies have shown that effector CD8+ T cells, which accumulate in the blister fluid, are functionally cytotoxic and act through a classical perforin/granzyme B pathway...
  5. Nishifuji K, Shimizu A, Ishiko A, Iwasaki T, Amagai M. Removal of amino-terminal extracellular domains of desmoglein 1 by staphylococcal exfoliative toxin is sufficient to initiate epidermal blister formation. J Dermatol Sci. 2010;59:184-91 pubmed publisher
    ..However, the precise mechanisms underlying ET-induced epidermal blister formation remain poorly understood...
  6. Koskela M, Gäddnäs F, Ala Kokko T, Laurila J, Saarnio J, Oikarinen A, et al. Epidermal wound healing in severe sepsis and septic shock in humans. Crit Care. 2009;13:R100 pubmed publisher
    ..It was hypothesised that epidermal wound healing is disturbed in severe sepsis. Blister wounds were induced in 35 patients with severe sepsis and in 15 healthy controls...
  7. Bubier J, Sproule T, Alley L, Webb C, Fine J, Roopenian D, et al. A mouse model of generalized non-Herlitz junctional epidermolysis bullosa. J Invest Dermatol. 2010;130:1819-28 pubmed publisher
    Epidermolysis bullosa (EB) is a class of intractable, rare, genetic disorders characterized by fragile skin and blister formation as a result of dermal-epidermal mechanical instability...
  8. Tabet R, Feldman R, Bell N, Lee D. "Bleb window"-pexy for the management of symptomatic, oversized blebs. J Glaucoma. 2009;18:546-51 pubmed publisher
    ..To describe a simple method and outcomes of remodeling dysesthetic, oversized filtering blebs...
  9. Has C, Burger B, Volz A, Kohlhase J, Bruckner Tuderman L, Itin P. Mild clinical phenotype of Kindler syndrome associated with late diagnosis and skin cancer. Dermatology. 2010;221:309-12 pubmed publisher
    ..Taken together, we describe the natural course of KS, the morphological abnormalities occurring in the skin of older KS patients, we discuss the differential diagnosis and the association between KS and squamous cell carcinoma. ..
  10. Al Turki T, Al Shahwan S, Al Mezaine H, Kangave D, Abu El Asrar A. Microbiology and visual outcome of bleb-associated endophthalmitis. Ocul Immunol Inflamm. 2010;18:121-6 pubmed publisher
    ..Clinical features associated with better visual outcome include early presentation, better presenting visual acuity, clear cornea at presentation, culture of a less virulent organism, and absence of diabetes mellitus. ..
  11. Dinh P, Corraza F, Mestdagh K, Kassengera Z, Doyen V, Michel O. Validation of the cantharidin-induced skin blister as an in vivo model of inflammation. Br J Clin Pharmacol. 2011;72:912-20 pubmed publisher
    Pharmacological profiling techniques, such as the cantharidin-induced skin blister, may be used to assess the anti-inflammatory properties of novel drugs...
  12. Yancey K, Hintner H. Non-herlitz junctional epidermolysis bullosa. Dermatol Clin. 2010;28:67-77 pubmed publisher
    ..Although nH JEB is generally less severe than Herlitz disease, fatalities (especially in neonates) are not uncommon among patients with the former diagnosis. ..
  13. Mao X, Li H, Sano Y, Gaestel M, Mo Park J, Payne A. MAPKAP kinase 2 (MK2)-dependent and -independent models of blister formation in pemphigus vulgaris. J Invest Dermatol. 2014;134:68-76 pubmed publisher
    ..2 (MK2) as a downstream effector of p38 signaling in PV and describe MK2-dependent and -independent mechanisms of blister formation using passive transfer of human anti-Dsg IgG4 mAbs to neonatal mice...
  14. Dainichi T, Koga H, Tsuji T, Ishii N, Ohyama B, Ueda A, et al. From anti-p200 pemphigoid to anti-laminin gamma1 pemphigoid. J Dermatol. 2010;37:231-8 pubmed publisher
    ..Unveiling the pathogenicity and development of a useful diagnostic method is necessary for appropriate management of this new disease. ..
  15. Sawamura D, Nakano H, Matsuzaki Y. Overview of epidermolysis bullosa. J Dermatol. 2010;37:214-9 pubmed publisher
    ..Cell-based therapies using fibroblasts and bone marrow cells have recently attracted considerable attention. ..
  16. He Y, Esser P, Heinemann A, Bruckner Tuderman L, Has C. Kindlin-1 and -2 have overlapping functions in epithelial cells implications for phenotype modification. Am J Pathol. 2011;178:975-82 pubmed publisher
    ..This first example of environmental regulation of kindlin expression has implications for phenotype modulation in Kindler syndrome, a skin disorder caused by kindlin-1 deficiency. ..
  17. Lai Cheong J, McGrath J. Kindler syndrome. Dermatol Clin. 2010;28:119-24 pubmed publisher characterized by impaired actin cytoskeleton-extracellular matrix interactions and a variable plane of blister formation at or close to the dermal-epidermal junction...
  18. Pan S, Wu L, Chen C, Shieh S, Chiu H. Angiogenin expression in burn blister fluid: implications for its role in burn wound neovascularization. Wound Repair Regen. 2012;20:731-9 pubmed publisher
    ..Although present in approximately equal amounts in both SPTB and DPTB blister fluids from burn patients, angiogenin does appear to be involved in the ability of DPTB blister fluid to promote ..
  19. Gäddnäs F, Sutinen M, Koskela M, Tervahartiala T, Sorsa T, Salo T, et al. Matrix-metalloproteinase-2, -8 and -9 in serum and skin blister fluid in patients with severe sepsis. Crit Care. 2010;14:R49 pubmed publisher
    ..The amounts of MMP-2, -8 and -9 were analyzed from serum at days 1, 4, 6, 8, and 10, and from skin suction blister fluid at days 1 and 5 from the beginning of severe sepsis...
  20. Mihai S, Chiriac M, Herrero González J, Goodall M, Jefferis R, Savage C, et al. IgG4 autoantibodies induce dermal-epidermal separation. J Cell Mol Med. 2007;11:1117-28 pubmed
    ..In this study, we isolated IgG1 and IgG4 autoantibodies from bullous pemhigoid patients'serum and analysed their blister-inducing potential in our cryosection assay...
  21. Wakugawa M, Nakamura K, Hino H, Toyama K, Hattori N, Okochi H, et al. Elevated levels of eotaxin and interleukin-5 in blister fluid of bullous pemphigoid: correlation with tissue eosinophilia. Br J Dermatol. 2000;143:112-6 pubmed
    ..In this study we measured eotaxin and IL-5 levels in blister fluid of BP by enzyme-linked immunosorbent assay...
  22. Liu Z, Zhou X, Shapiro S, Shipley J, Twining S, Diaz L, et al. The serpin alpha1-proteinase inhibitor is a critical substrate for gelatinase B/MMP-9 in vivo. Cell. 2000;102:647-55 pubmed
    ..Mice deficient in either GB or neutrophil elastase (NE) are resistant to blister formation in response to these antibodies in a mouse model of the autoimmune disease bullous pemphigoid...
  23. Theelen T, Wesseling P, Keunen J, Klevering B. A pilot study on slit lamp-adapted optical coherence tomography imaging of trabeculectomy filtering blebs. Graefes Arch Clin Exp Ophthalmol. 2007;245:877-82 pubmed
    ..Successful filtering blebs show characteristic optical properties on SL-OCT. These phenomena suggest a diffusely enhanced fluid content and the presence of intra-bleb drainage channels in functional filtering blebs. ..
  24. Sitaru C, Chiriac M, Mihai S, Büning J, Gebert A, Ishiko A, et al. Induction of complement-fixing autoantibodies against type VII collagen results in subepidermal blistering in mice. J Immunol. 2006;177:3461-8 pubmed
    ..This robust experimental system should greatly facilitate further studies on the pathogenesis of EBA and the development of novel immunomodulatory therapies for this and other autoimmune diseases. ..
  25. Paladini R, Coulombe P. The functional diversity of epidermal keratins revealed by the partial rescue of the keratin 14 null phenotype by keratin 16. J Cell Biol. 1999;146:1185-201 pubmed
    ..Mice null for K14 blister extensively and die approximately 2 d after birth (Lloyd, C., Q.C. Yu, J. Cheng, K. Turksen, L. Degenstein, E...
  26. Ochiai T, Morishima T, Hao T, Takayama A. Bullous amyloidosis: the mechanism of blister formation revealed by electron microscopy. J Cutan Pathol. 2001;28:407-11 pubmed
    Few electron microscopic studies of blister lesions in bullous amyloidosis have been reported, and the mechanism of blister formation remains to be elucidated...
  27. Hanakawa Y, Schechter N, Lin C, Garza L, Li H, Yamaguchi T, et al. Molecular mechanisms of blister formation in bullous impetigo and staphylococcal scalded skin syndrome. J Clin Invest. 2002;110:53-60 pubmed
    ..aureus to spread under the stratum corneum, the main barrier of the skin, explaining how, although they circulate through the entire body in SSSS, they cause pathology only in the superficial epidermis...
  28. Ito K, Miura K, Sugimoto K, Matsunaga K, Sasoh M, Uji Y. Use of indocyanine green during excision of an overhanging filtering bleb. Jpn J Ophthalmol. 2007;51:57-9 pubmed
    ..Injection of ICG into an overhanging filtering bleb during excision can be useful in the prevention of damage to the original bleb. ..
  29. Groeneweg J, Huygen F, Heijmans Antonissen C, Niehof S, Zijlstra F. Increased endothelin-1 and diminished nitric oxide levels in blister fluids of patients with intermediate cold type complex regional pain syndrome type 1. BMC Musculoskelet Disord. 2006;7:91 pubmed
    ..The aim of this study was to determine the involvement of vasoactive substances endothelin-1 (ET-1) and nitric oxide (NO) during early chronic CRPS1...
  30. Shi X, Gillespie P, Nuttall A. Na+ influx triggers bleb formation on inner hair cells. Am J Physiol Cell Physiol. 2005;288:C1332-41 pubmed
    ..We conclude that IHC bleb formation differs from classic blebbing mechanisms and that IHC blebs arise from imbalance of endocytosis and exocytosis in the apical plasma membrane, linked to Na(+) loading that occurs in vitro. ..
  31. Sherwood M. A sequential, multiple-treatment, targeted approach to reduce wound healing and failure of glaucoma filtration surgery in a rabbit model (an American Ophthalmological Society thesis). Trans Am Ophthalmol Soc. 2006;104:478-92 pubmed
    ..It is not known whether these findings can be reproduced in humans, and further work is needed to determine an optimum regimen and timing of therapeutic delivery. ..
  32. Kitajima Y. Mechanisms of desmosome assembly and disassembly. Clin Exp Dermatol. 2002;27:684-90 pubmed
    ..The key implications for understanding desmosome dynamics from these findings are summarized in this review. ..
  33. Huygen F, Ramdhani N, van Toorenenbergen A, Klein J, Zijlstra F. Mast cells are involved in inflammatory reactions during Complex Regional Pain Syndrome type 1. Immunol Lett. 2004;91:147-54 pubmed
    ..Involvement of mast cells is relatively easy to detect by measurement of tryptase...
  34. Huygen F, Niehof S, Zijlstra F, van Hagen P, van Daele P. Successful treatment of CRPS 1 with anti-TNF. J Pain Symptom Manage. 2004;27:101-3 pubmed
  35. Lane J, Brown C, Lesher J, Hashem B, Marzec T. Pressure-induced bullae and sweat gland necrosis following chemotherapy induction. Am J Med. 2004;117:441-3 pubmed
  36. Mazereeuw Hautier J, Gres S, Fanguin M, Cariven C, Fauvel J, Perret B, et al. Production of lysophosphatidic acid in blister fluid: involvement of a lysophospholipase D activity. J Invest Dermatol. 2005;125:421-7 pubmed
    ..Nevertheless, its presence in the skin has never been investigated. Since re-epithelialization occurs after blister rupture, we tested the presence of endogenous LPA in blister fluid and investigated a possible mechanism for its ..
  37. Prasad N, Latina M. Blebitis and endophthalmitis after glaucoma filtering surgery. Int Ophthalmol Clin. 2007;47:85-97 pubmed
  38. Wenzel F, Horn T. Nonneoplastic disorders of the eccrine glands. J Am Acad Dermatol. 1998;38:1-17; quiz 18-20 pubmed
    ..Alterations in the electrolyte composition of eccrine sweat can be observed in several systemic diseases, most notably cystic fibrosis. This article summarizes current knowledge of eccrine gland pathophysiology...
  39. Ferreli C, Sulica V, Aste N, Atzori L, Pinna M, Biggio P. Drug-induced sweat gland necrosis in a non-comatose patient: a case presentation. J Eur Acad Dermatol Venereol. 2003;17:443-5 pubmed
    ..Skin blisters with underlying sweat gland necrosis is an entity previously reported to occur in comatose patients, our findings open new questions about the role of the drugs in the pathogenesis of those conditions. ..
  40. Sitaru C, Mihai S, Zillikens D. The relevance of the IgG subclass of autoantibodies for blister induction in autoimmune bullous skin diseases. Arch Dermatol Res. 2007;299:1-8 pubmed
    ..Existing clinical and experimental evidence generally supports a pathogenic role of autoantibodies for blister formation...
  41. Frohm M, Gunne H, Bergman A, Agerberth B, Bergman T, Boman A, et al. Biochemical and antibacterial analysis of human wound and blister fluid. Eur J Biochem. 1996;237:86-92 pubmed
    Fluid from a post-operative wound, six leg ulcers and a large blister were collected and analysed by biochemical, microbiological and immunological techniques. The results were compared with those from sera...
  42. Polak M, Valamanesh F, Felt O, Torriglia A, Jeanny J, Bourges J, et al. Controlled delivery of 5-chlorouracil using poly(ortho esters) in filtering surgery for glaucoma. Invest Ophthalmol Vis Sci. 2008;49:2993-3003 pubmed publisher
    ..Thus, the slow release of POE/5-CU may be beneficial for the prevention of bleb closure in patients who undergo complicated trabeculectomy. ..
  43. Kawasaki H, Tsunoda K, Hata T, Ishii K, Yamada T, Amagai M. Synergistic pathogenic effects of combined mouse monoclonal anti-desmoglein 3 IgG antibodies on pemphigus vulgaris blister formation. J Invest Dermatol. 2006;126:2621-30 pubmed
    ..epitopes using domain-swapped and point-mutated Dsg1/Dsg3 molecules and examined their pathogenic activities in blister formation in three different assays...
  44. Sekula R, Cohen D, Quigley M, Jannetta P. Primary treatment of a blister-like aneurysm with an encircling clip graft: technical case report. Neurosurgery. 2006;59:ONSE168; discussion ONSE168 pubmed
    b>Blister-like aneurysms at nonbranching sites in the supraclinoid portion of the internal carotid artery are a rare but important cause of subarachnoid hemorrhage...
  45. Correia O, Delgado L, Roujeau J, Le Cleach L, Fleming Torrinha J. Soluble interleukin 2 receptor and interleukin 1alpha in toxic epidermal necrolysis: a comparative analysis of serum and blister fluid samples. Arch Dermatol. 2002;138:29-32 pubmed
    ..In the blister fluid of patients with TEN, we found significantly higher levels of sIL-2R than in patients with burns, whereas ..
  46. Chi C, Wang S, Charles Holmes R, Ambros Rudolph C, Powell J, Jenkins R, et al. Pemphigoid gestationis: early onset and blister formation are associated with adverse pregnancy outcomes. Br J Dermatol. 2009;160:1222-8 pubmed publisher
    ..Systemic corticosteroid treatment, in contrast, does not substantially affect pregnancy outcomes, and its use for PG in pregnant women is justified. ..
  47. Dowling J, Yu Q, Fuchs E. Beta4 integrin is required for hemidesmosome formation, cell adhesion and cell survival. J Cell Biol. 1996;134:559-72 pubmed
  48. Lazarova Z, Yee C, Darling T, Briggaman R, Yancey K. Passive transfer of anti-laminin 5 antibodies induces subepidermal blisters in neonatal mice. J Clin Invest. 1996;98:1509-18 pubmed
    ..These studies establish an animal model of a human blistering disease that can be used to define disease mechanisms and treatment modalities. ..
  49. Huygen F, De Bruijn A, De Bruin M, Groeneweg J, Klein J, Zijlstra F. Evidence for local inflammation in complex regional pain syndrome type 1. Mediators Inflamm. 2002;11:47-51 pubmed
    ..In plasma, no changes of mediators of inflammation were observed. In blister fluid, however, significantly higher levels of IL-6 and TNF-alpha in the involved extremity were observed in ..
  50. Shu E, Yamamoto Y, Aoyama Y, Kitajima Y. Intraperitoneal injection of pemphigus vulgaris-IgG into mouse depletes epidermal keratinocytes of desmoglein 3 associated with generation of acantholysis. Arch Dermatol Res. 2007;299:165-7 pubmed
    ..We showed that injection of PV-IgG into neonatal mice caused suprabasal blister formation and approximately 30% reduction of Dsg3 in mouse epidermal keratinocytes, compared to mice injected ..
  51. Wimmer I, Welge Luessen U, Picht G, Grehn F. Influence of argon laser trabeculoplasty on transforming growth factor-beta 2 concentration and bleb scarring following trabeculectomy. Graefes Arch Clin Exp Ophthalmol. 2003;241:631-6 pubmed
    ..053). ALT appears to increase the risk of scarring in XFS patients because of increased levels of activated TGF-beta 2. ..
  52. Singh M, Chew P, Friedman D, Nolan W, See J, Smith S, et al. Imaging of trabeculectomy blebs using anterior segment optical coherence tomography. Ophthalmology. 2007;114:47-53 pubmed
    ..Thickening of the bleb wall was typically absent. AS-OCT is a promising tool to image trabeculectomy blebs. It was able to demonstrate features of bleb morphology not visible with the slit lamp. ..
  53. Günther C, Wozel G, Dressler J, Meurer M, Pfeiffer C. Tissue eosinophilia in pemphigoid gestationis: association with eotaxin and upregulated activation markers on transmigrated eosinophils. Am J Reprod Immunol. 2004;51:32-9 pubmed
    ..Eotaxin and interleukin (IL)-5 were analysed in patients' blister fluid and serum by enzyme-linked immunosorbent assay...