A patient experiencing coma after a drug overdose may develop skin blisters.
Clinical findings: blisters or bullae on the limbs and/or trunk
Drugs associated with coma blisters or bullae:
(1) barbiturates
(2) benzodiazepines
(3) ethanol
(4) antipsychotic agents
(5) antidepressants
(6) opioids
(7) any other CNS depressant
Biopsy shows epidermal and eccrine sweat gland necrosis with or without thrombosis in small blood vessels.
Complications:
(1) evolution into necrotic skin ulcers.
(2) scarring
(3) subcutaneous and soft tissue involvement
(4) functional impairment
Coma blisters can occur in other causes of coma such as severe hypoglycemia and meningoencephalitis.
