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Coma blisters in children: case report and review of the literature

Laura Bosco1, Donatella Schena, Chiara Colato

  • 11Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy.

Journal of Child Neurology
|November 17, 2012
PubMed

Insights

Coma-induced blisters, a rare skin condition, can occur in children with severe neurological impairment like meningoencephalitis. This case highlights the importance of clinical-pathologic correlation for accurate diagnosis in pediatric patients.

Area of Science:

  • Pediatric Dermatology
  • Neurology
  • Pathology

Background:

  • Coma-induced blisters (coma bullae) are a rare phenomenon typically associated with drug overdose in adults.
  • Limited pediatric cases of coma bullae have been documented, making this condition poorly understood in children.

Observation:

  • A case report details an 11-year-old child experiencing coma bullae secondary to meningoencephalitis.
  • The bullous lesions appeared on the trunk and limbs, progressing to necrotic ulcers.
  • No drug overdose was identified as the cause in this pediatric patient.

Findings:

  • Skin biopsy revealed epidermal and eccrine sweat gland necrosis with neutrophilic infiltration.
  • Dermal vessel thrombosis was observed, suggesting a vascular component.
  • Literature review confirmed only five previously reported pediatric cases of coma bullae.

Implications:

  • This case expands the understanding of coma bullae in pediatric populations, particularly in the context of non-overdose-related neurological conditions.
  • Accurate diagnosis requires distinguishing coma bullae from other pediatric blistering disorders through clinical and pathological evaluation.
  • Coma bullae demonstrate spontaneous resolution, emphasizing supportive care and accurate diagnosis.

Keywords:
blisterscomameningoencephalitisseizures

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