Coma blisters after poisoning caused by central nervous system depressants: case report including histopathological findings.

نویسندگان

  • Maira Migliari Branco
  • Eduardo Mello De Capitani
  • Maria Letícia Cintra
  • Stephen Hyslop
  • Adriana Camargo Carvalho
  • Fabio Bucaretchi
چکیده

Blister formation and eccrine sweat gland necrosis is a cutaneous manifestation associated with states of impaired consciousness, most frequently reported after overdoses of central nervous system depressants, particularly phenobarbital. The case of a 45-year-old woman who developed "coma blisters" at six distinct anatomic sites after confirmed (laboratory) phenobarbital poisoning, associated with other central nervous system depressants (clonazepam, promethazine, oxcarbazepine and quetiapine), is presented. A biopsy from the left thumb blister taken on day 4 revealed focal necrosis of the epidermis and necrosis of sweat gland epithelial cells; direct immunofluorescence was strongly positive for IgG in superficial blood vessel walls but negative for IgM, IgA, C3 and C1q. The patient was discharged on day 21 with no sequelae.

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عنوان ژورنال:
  • Anais brasileiros de dermatologia

دوره 87 4  شماره 

صفحات  -

تاریخ انتشار 2012