Coma bullae in Adult
They occur in comatose or immobile patients at points of maximum pressure and in patients with neurologic disorders. They form within 48-72 hours after the immobility. They can be skin colored or red / purple from hemorrhage. Coma bullae have been associated with barbiturate overdose.
L13.8 – Other specified bullous disorders
339008 – Blister
Differential Diagnosis & Pitfalls
- Epidermolysis bullosa acquisita – Patients usually have a history of blisters at multiple sites with even minimal friction. Histopathology can confirm diagnosis.
- Epidermolysis bullosa simplex – Patients usually have a history of blisters at multiple sites on the hands and feet. Histopathology can confirm diagnosis.
- Bullosis diabeticorum – Patients have diabetes mellitus.
- Stasis bullae (see also stasis dermatitis) – More common symmetrically around the lower legs.
- Lymphedema – Common in immobile hospitalized patients and found in areas of dependent edema, but not at direct points of pressure. May arise during diuresis.
- Bullous fixed drug eruption – Round bullae, usually associated with more inflammation and red-brown plaques underlying the bullae.
Drug Reaction Data