ContentsSynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyDrug Reaction DataReferencesView all Images (5)
Coma bullae in Adult
Print
Other Resources UpToDate PubMed

Coma bullae in Adult

Print Images (5)
Contributors: Aman Samrao MD, Belinda Tan MD, PhD, Whitney A. High MD, JD, MEng
Other Resources UpToDate PubMed

Synopsis

Coma bullae are typically large bullae that are caused by physical forces.

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.

Codes

ICD10CM:
L13.8 – Other specified bullous disorders

SNOMEDCT:
339008 – Blister

Look For

Subscription Required

Diagnostic Pearls

Subscription Required

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.

Best Tests

Subscription Required

Management Pearls

Subscription Required

Therapy

Subscription Required

Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

Subscription Required

References

Subscription Required

Last Updated: 09/06/2017
Copyright © 2019 VisualDx®. All rights reserved.
Coma bullae in Adult
Print 5 Images
View all Images (5)
(with subscription)
Coma bullae : Coma, Flaccid bullae, Pressure exposure, Tense bullae, Immobilized patient
Clinical image of Coma bullae
Copyright © 2019 VisualDx®. All rights reserved.