@article{ref1,
title="Coma blisters after poisoning caused by central nervous system depressants: case report including histopathological findings",
journal="Anais Brasileiros de Dermatologia",
year="2012",
author="Branco, Maí­ra Migliari and Capitani, Eduardo Mello de and Cintra, Maria Letícia and Hyslop, Stephen and Carvalho, Adriana Camargo and Bucaretchi, Fábio",
volume="87",
number="4",
pages="615-617",
abstract="Blister formation and eccrine sweat gland necrosis is a cutaneous manifestation associated with states of impaired consciousness, most frequently reported after overdoses of central nervous system depressants, particularly phenobarbital. The case of a 45-year-old woman who developed &quot;coma blisters&quot; at six distinct anatomic sites after confirmed (laboratory) phenobarbital poisoning, associated with other central nervous system depressants (clonazepam, promethazine, oxcarbazepine and quetiapine), is presented. A biopsy from the left thumb blister taken on day 4 revealed focal necrosis of the epidermis and necrosis of sweat gland epithelial cells; direct immunofluorescence was strongly positive for IgG in superficial blood vessel walls but negative for IgM, IgA, C3 and C1q. The patient was discharged on day 21 with no sequelae.<p /> <p>Language: en</p>",
language="en",
issn="0365-0596",
doi="",
url="http://dx.doi.org/"
}