Citation

Czekalla J, Springfeld C, Goos M, Gastpar M. MMW Munch. Med. Wochenschr. 1997; 139(17): 266-268.

Copyright

(Copyright © 1997, Verlagsgesellschaft OttoSpatz)

DOI

unavailable

PMID

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Abstract

Bullae, erosions, and violaceous plaques have been described in comatose patients with exposure to barbiturates, opioids, and benzodiazepines more often than in patients with non-drug-induced coma. Bullae were originally believed to be pathognomonic of barbiturate-induced coma ('coma bullae'). Meanwhile, similar clinical lesions are reported in drug overdosage due to methadone and combinations with amitriptyline and imipramine. It remains unclear whether such lesions are due to pressure, a drug effect, or both. Thus, we report on a case of 'coma bullae' by a new suicidal intoxication with doxepin. Skin blisters formed or persisted over 14 days. In case of comatose patients with blisters of the skin and suspicion of a suicide attempt, intoxication with doxepin or another tricyclic antidepressant should be included in differential diagnosis.

Language: de