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Difference Between Vesicular and Pustular

Vesicular is a term relating to the formation of vesicles while pustular is a term relating to the formation of pustules.

What is Vesicular?


Vesicular is a term referring to the vesicles (blisters) of a skin rash.


Vesicles often develop on the skin when a person has a herpes infection but it can also be because of contact dermatitis. In the case of herpes, the vesicle might help protect the virus from the immune system. The autoimmune disease, dermatitis herpetiformis, is another cause of vesicle formation. An uncommon condition known as hereditary hypotrichosis can also produce vesicles. Vesicles can also form after certain types of burns or as allergic reactions to medications. 

Appearance of lesions:

A vesicle is also called a blister and it appears as a swollen area of skin that contains clear fluid. Vesicles tend to be small, often less than 5 mm in size.


Vesicles are first diagnosed by appearance. However, it can sometimes be useful to have a biopsy done if a doctor is unsure why you have skin vesicles. Diagnosis can help a doctor decide on the best course of treatment for you. 


The treatment of a vesicular rash really depends on what the cause of the condition is. For instance, herpes infections can be treated with antiviral creams.

What is Pustular?


Pustular is a term used to refer to the development of pustules on the skin.


Pustules can be caused by a number of conditions including acne, psoriasis, and folliculitis. It can also occur when a person has a bacterial infection of the skin. It even can happen if a person has developed endocarditis or septicemia.

Appearance of lesions:

The appearance of a pustule is that of a bump with a white top part. These lesions are also between 5 mm and 10 mm in diameter. The fluid inside a pustule is yellow and consists of various types of white blood cells, including neutrophils.


Pustules can be identified by their appearance. A biopsy is sometimes done to identify if there are microbial organisms present so that one can identify the exact pathogen. A skin sample and sample of the fluid is taken and examined for fungi or bacteria, which could be causing the problem. 


Treatment options may include using benzoyl peroxide gel and salicylic acid creams. Antibiotics may also be prescribed and necessary if the person has a serious infection.

Difference between Vesicular and Pustular?


Vesicular is a term that refers to the development and presence of vesicles as part of a skin rash. Pustular is a term that means the development and presence of pustules as part of a skin rash.

Lesion appearance

A vesicle appears as a small bump that is clear and contains fluid. A pustule appears as a slightly raised bump that has yellow-colored pus inside it.

Lesion size

The size of a vesicle is less than 5 mm. The size of a pustule is between 5 mm and 10 mm. 

Contents of lesion

A vesicle contains clear fluid. A pustule contains white blood cells, particularly abundant neutrophils.


The causes of vesicles include herpes, eczema, burns, contact dermatitis, hereditary hypotrichosis, and dermatitis herpetiformis. The causes of pustules include psoriasis, folliculitis, certain bacterial infections, endocarditis, and septicemia.


The treatment options for vesicular rashes depend on the cause and may include the use of antivirals. The treatment options for pustular rashes may include the use of antibiotics and benzoyl peroxide gels.

Table comparing Vesicular and Pustular

Summary of Vesicular Vs. Pustular

  • Vesicular and pustular are both terms used to describe certain skin bumps.
  • Vesicles are blisters that have clear fluid inside them.
  • Pustules are bumps that contain white blood cells.
  • Treatment of a vesicular or pustular rash depends on what the cause of the problem is.


What is the difference between a vesicular rash and a pustular rash?

A vesicular rash is when a skin rash also has vesicles present. A pustular rash is when a skin rash also has pustules present.

What are the differences between vesicles bullas macules and pustules?

Bullas macules vesicles are those vesicles that are flat and bigger than 5 mm in diameter. A pustule is also larger than 5 mm but the difference is, it contains pus, unlike a bullas macules vesicle.

What is a vesicular lesion?

A vesicular lesion is a vesicle that contains clear fluid and is also known as a blister.

What is an example of a vesicular rash?

The shingles rash is a good example of a vesicular rash. In the case of shingles, the rash is along a nerve. The affected nerve and nerve root is where the vesicles will appear if you have shingles.

How do you identify pustules?

Pustules occur as bumps that have a white colored central part.

What is pustular skin?

Pustular skin is skin that contains pustules. Sometimes people with bad acne develop pustules and can be said to have pustular skin.

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References :

[0]Bello-Morales, Raquel, and José Antonio López-Guerrero. "Extracellular vesicles in herpes viral spread and immune evasion." Frontiers in microbiology 9 (2018): 2572.

[1]Benedetti, Julia. “Description of skin lesions”. Merckmanuals. Merck & Co., 2022, https://www.msdmanuals.com/professional/dermatologic-disorders/approach-to-the-dermatologic-patient/description-of-skin-lesions#v958358

[2]Lipsker, Dan, and Dan Lipsker. "Pustules." Clinical Examination and Differential Diagnosis of Skin Lesions (2013): 181-182.

[3]Image credit: https://www.canva.com/photos/MAFJdEyg4U0-concept-of-monkey-pox-infection-a-white-asian-man-with-pustular/

[4]Image credit: https://www.canva.com/photos/MAEJFkWcWB8-medical-skin-condition-vesicular-dermatitis/

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