title: Coma blisters in children: case report and review of the literature.
abstract: Coma-induced blisters is a rare condition associated with prolonged impairment of conscious level, which is relatively well-known in adults following overdose with barbiturates. However, it has been very rarely described in children. A case of coma-bullae occurring in an 11-year-old child with meningoencephalitis is herein reported. The bullous lesions occurred on the limbs and trunks, and evolved into necrotic ulcers in a few days. No correlation with any drug overdosage was found. A skin biopsy revealed epidermal and eccrine sweat gland necrosis with abundant neutrophils, and thrombosis of the vessels in the lower dermis. A comprehensive review of the literature showed that only 5 cases of coma-bullae in children have been published so far. Coma blistering resolves spontaneously within days or weeks. Diagnosis of coma-bullae may require careful clinical-pathologic correlation to exclude other blistering diseases in children.
authors.affiliation: 1Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Bosco
authors.forename: Donatella
authors.initials: D
authors.lastname: Schena
authors.forename: Chiara
authors.initials: C
authors.lastname: Colato
authors.forename: Paolo
authors.initials: P
authors.lastname: Biban
authors.forename: Giampiero
authors.initials: G
authors.lastname: Girolomoni
mesh_terms: D001768:Blister / Q000209:etiology*; D002648:Child; D003128:Coma / Q000150:complications*; D005121:Extremities / Q000473:pathology; D006801:Humans; D008297:Male; D013545:Sweat Glands / Q000473:pathology