Bullous reaction to cupping therapy

A 54-year-old African American male presented with pruritic, circular, purpuric lesions, following a cupping service 4 days prior. The patient had a history of eczematoid dermatitis, scalp folliculitis and xerosis cutis. Upon examination, 13 lesions were identified with a diameter of 6 cm each. These lesions contained both bullae and vesicles concentrated along the perimeter of the lesions. All lesions showed varying degrees of ecchymosis. The diagnosis of iatrogenic-induced bullae was made and topical zinc-oxide astringent ointment was prescribed for BID use. Follow up examination revealed significant healing with all bullae flattened. The patient reported no pain but had minor complaints of residual pruritic hyperpigmentation. He was prescribed Triamcinolone Acetonide 0.005% ointment BID for these areas with good recovery. Increasing popularity in cupping requires that physicians be aware of the adverse effects. Appropriate patient education is of importance when one is seeking advice on whether to undergo cupping therapy