Document Detail

Coma blisters with hypoxemic respiratory failure.
MedLine Citation:
PMID:  22483521     Owner:  NLM     Status:  MEDLINE    
A 24-year-old woman with quadriplegia was admitted with respiratory failure because of pneumonia. She was on multiple medications including diazepam, oxycodone, and amitriptyline, known to be associated with coma blisters, though she did not overdose on any of them. On hospital day 2, she developed multiple blisters on both sides of her right forearm and hand. Skin biopsy showed eccrine gland degeneration consistent with coma blisters. It was felt that hypoxemia from her pneumonia contributed to the development of these blisters, which occurred on both pressure and non-pressure bearing areas of the arm. Coma blisters are self-limited skin lesions that occur at sites of maximal pressure, mostly in the setting of drug overdose. However, coma blisters may occur with metabolic and neurological conditions resulting in coma.
Abhishek Agarwal; Meghana Bansal; Kelly Conner
Publication Detail:
Type:  Case Reports; Journal Article     Date:  2012-03-15
Journal Detail:
Title:  Dermatology online journal     Volume:  18     ISSN:  1087-2108     ISO Abbreviation:  Dermatol. Online J.     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-04-09     Completed Date:  2012-08-03     Revised Date:  2012-10-04    
Medline Journal Info:
Nlm Unique ID:  9610776     Medline TA:  Dermatol Online J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  10     Citation Subset:  IM    
Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
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MeSH Terms
Amitriptyline / therapeutic use
Anti-Bacterial Agents / therapeutic use
Blister / diagnosis,  etiology*,  pathology
Coma / complications*
Diazepam / therapeutic use
Drug Therapy, Combination
Mianserin / analogs & derivatives,  therapeutic use
Oxycodone / therapeutic use
Oxygen / therapeutic use
Penicillanic Acid / analogs & derivatives,  therapeutic use
Piperacillin / therapeutic use
Pneumonia / complications
Pneumonia, Aspiration / drug therapy
Quadriplegia / drug therapy
Respiratory Insufficiency / etiology
Treatment Outcome
Young Adult
Reg. No./Substance:
0/Anti-Bacterial Agents; 157044-21-8/piperacillin-tazobactam combination product; 24219-97-4/Mianserin; 439-14-5/Diazepam; 50-48-6/Amitriptyline; 61337-67-5/mirtazapine; 61477-96-1/Piperacillin; 76-42-6/Oxycodone; 7782-44-7/Oxygen; 87-53-6/Penicillanic Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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