Elderly father with large blisters on leg

[Seeingadistance]

My DF is in late 80s, with dementia. Lives at home with my DM. He does eat more than he used to, forgets he’s eaten, but is overweight rather than obese, and although walks very slowly, is constantly walking about the house and garden, so reasonably active.

Last year he had a few water blisters on one leg. Blisters about 2 or 3 inches in diameter, no apparent cause. He now has these blisters again. They are not painful or itchy - he was unaware of them but one burst and my DM noticed the damp patch on his trousers. They always appear on the same leg, above the knee. No rash. He doesn’t sit with his legs crossed or with anything on his lap so not caused by pressure or friction.

Hasn’t seen GP yet, but practice nurse can’t work out what’s going on.

He has a history of excema, since childhood but that was mostly restricted to hands, elbows etc.

Any ideas?

My first concern would be diabetes and I'd make it a point of ruling that out. The nurse should do some bloods.

My dad had recurrent blistering, but it was part of an autoimmune skin disorder he was diagnosed with in his late 70's after recurrent non healing mouth ulcers.
He needs to be seen by the GP as blistering can really be a conduit to infection and skin breakdown.

He doesn't sit with his mug of tea on his leg though? Does he have normal feeling in that area if it's touched?

Could his trousers be rubbing against his skin causing a friction type injury?

Good points about the tea and the friction type injury.
My dad too, when he was alive, had similar sores on his legs due to his SLE (Lupus), blistery type sores on the arms. Itchy skin. Not painful.
CMOTdibbler had mentioned autoimmune disorders. Mention this and diabetes to the GP/nurse.

My late DM had this autoimmune disease, called Bullous Pemphigoid, she had it on her back and thigh, diagnosis by biopsy eventually, took ages for GP to refer, kept just giving antibiotics and dressings. Once diagnosed went on high dose steroids, tapered off very slowly, on them 5_6 years, but didn’t recurr after initial presentation. Quite common in elderly we were told, yet always had to explain it to blank looks whenever a medical discussion took place! Needed osteoporosis prevention in conjunction with the steroids.

Sounds like Pemphigoid. If he’s housebound you will need the District Nurses to visit and dress his legs.

Thanks for your comments.

My DM has been taking him to GP surgery twice a week to have the blisters dressed by Practice Nurse, who doesn’t know what the cause might be.

I’ll say to my DM to see if he is resting hot cup on leg, but that seems unlikely to be honest. There is no redness at all, no signs of friction, and no reason to think that clothes might be rubbing.

Spoke to DM today and suggested diabetes. She said he’s has blood tests which have come back normal. She also says that it was about 3 years ago that he had these blisters before, on the same leg and same position. They healed, leaving pale scars, and nothing until about 6 weeks ago.

One blister is infected, being treated, and my DF says it is painful. Unless infected, there is no pain, no itching. Just these big blisters.

I’ve Googled pemphigoid, thanks for the suggestion. That doesn’t seem to fit either, as there is no redness or other disruption or change to the skin, other than these large water blisters. DM says fluid in blisters is pale yellow, straw colour.

They were at surgery today, and it seems that nurse is going to recommend referral to dermatology.