Coma blisters with deep soft tissue involvement after drug overdose

Ruiz-Rivero, Juncal; Pulido‐Pérez, Ana; Suárez‐Fernández, R.

doi:10.1111/ijd.13658

Cited by 3 publications

(6 citation statements)

References 4 publications

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“…Ruiz-Rivero et al [8] described a sudden and rapid onset of hemorrhagic and serous blisters symmetrically distributed over the legs, heels, dorsum of toes, and back of the hands (Fig. 1E and F).…”

Section: Diagnosismentioning

confidence: 98%

“…The physical examination showed tense clear fluid-filled blisters on well-delimited erythematous plaques. A 49-year-old man was admitted to the emergency room with progressive loss of consciousness after an attempted suicide with tricyclic antidepressant, opioids, and benzodiazepine overdose [8].…”

Section: Epidemiology and Clinical Featuresmentioning

confidence: 99%

“…A and B -Tense and fluid-filled blisters in the palmar surface and dorsum of each finger; C -Tense clear fluid-filled blisters on well-delimited erythematous plaques on the metacarpophalangeal joints; D -Similar lesions on the left knee with an artefactual morphology; E -Hemorrhagic tense blisters over the left heel; F -Flaccid blisters over the toes. A and B reprinted with permission from [17], C and D from [27], and E and F from [8].…”

Section: Diagnosismentioning

confidence: 99%

“…The prompt recognition of coma blisters with pain is important since raised interstitial pressures can cause irreversible nerve and muscle damage [8]. Moreover, from a clinical and forensic perspective good knowledge of the signs related to acute and chronic intoxications represents an important step of suspicion to orientate further toxicological analysis [9][10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, from a clinical and forensic perspective good knowledge of the signs related to acute and chronic intoxications represents an important step of suspicion to orientate further toxicological analysis [9][10][11][12][13][14]. Indeed, for some authors, coma blisters with deep soft tissue are hardly described in the literature and probably under-recognized or even misdiagnosed as cellulitis or other disorders [8] and most literature data is focused on the description of isolated case reports. Therefore, this work aims to perform a fully integrated review the state of the art regarding cause, pathophysiology, diagnosis and treatment of drug overdose-induced coma blisters.…”

Section: Introductionmentioning

confidence: 99%

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Drug Overdose-Induced Coma Blisters: Pathophysiology and Clinical and Forensic Diagnosis

Dinis-Oliveira

2019

CDRR

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Background: Coma blisters or coma bullae are bullous lesions that have been associated with cases of drug overdose-induced coma. Previous history of suicide attempt by administering benzodiazepines, barbiturates, ethanol, antipsychotics, antidepressants or opioids have been particularly implicated. Patients may present also painful deep skin and soft tissue involvement, edema and functional impairment. The pathophysiology remains unknown and lesions are usually self-limited and typically resolve without scarring. Objective: This work aims to fully review the state of the art regarding the causes pathophysiology, diagnosis and treatment of drug overdose-induced coma blisters. Conclusion: Coma blisters are a benign, self-limiting condition that should be suspected in patients who develop pressure blisters several hours after an altered state of consciousness.

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Section: Diagnosismentioning

confidence: 98%

Section: Epidemiology and Clinical Featuresmentioning

confidence: 99%

Section: Diagnosismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Drug Overdose-Induced Coma Blisters: Pathophysiology and Clinical and Forensic Diagnosis

Dinis-Oliveira

2019

CDRR

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Cutaneous eccrine inflammation and necrosis: review of inflammatory disorders affecting the eccrine apparatus including new associations

et al. 2021

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A Case of Coma Bullae Associated with Brachioradial Artery

Niu¹,

Deng²,

Wu³

et al. 2023

CCID

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We present the first case of coma bullae observed in a 67-year-old woman due to pressure and ischemia associated with brachioradial artery. A skin biopsy taken from the ulcer border revealed extensive loss of the epidermis, fibrosis of dermis, mild infiltration by lymphocytes and neutrophils, and necrosis of the focal eccrine ducts. CT angiography of the right upper limb showed a high origin of the radial artery, meanwhile both high originating radial artery and the anastomoses were tortuous and were of relatively small caliber. The diagnosis of coma bullae was made. After tissue debridement, the skin lesions gradually recovered, leaving atrophic scars.

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Coma blisters with deep soft tissue involvement after drug overdose

Cited by 3 publications

References 4 publications

Drug Overdose-Induced Coma Blisters: Pathophysiology and Clinical and Forensic Diagnosis

Drug Overdose-Induced Coma Blisters: Pathophysiology and Clinical and Forensic Diagnosis

Cutaneous eccrine inflammation and necrosis: review of inflammatory disorders affecting the eccrine apparatus including new associations

A Case of Coma Bullae Associated with Brachioradial Artery

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