1/15. Epileptic disorder as the first neurologic manifestation of blue rubber bleb nevus syndrome.Blue rubber bleb nevus syndrome is an uncommon neurocutaneous disorder characterized by distinctive vascular malformations on the body surface. vascular malformations of internal organs (typically the gastrointestinal tract) are also frequently present. However, malformations of the central nervous system have only rarely been described. We report a case of blue rubber bleb nevus syndrome in a 5-month-old boy with cutaneous manifestations characteristic of this process present from birth and multiple cerebral angiomas detected by magnetic resonance imaging. At age 1(1/2) months, the patient showed myoclonic seizures and complex partial seizures that were refractory to various antiepileptic regimens. At age 5 months, electroencephalograms (EEGs) showed continuous generalized slow spike-waves, predominantly in the right temporal region; however, EEGs normalized after induction of coma with intravenous midazolam. At age 13 months, the patient suffered from occasional seizures and slightly retarded psychomotor development. epilepsy is rare in this syndrome but as in other neurocutaneous syndromes (e.g., sturge-weber syndrome) can compromise psychomotor development; thus, every effort should be made to control seizures.- - - - - - - - - - ranking = 1keywords = coma (Clic here for more details about this article) |
2/15. Coma blisters in a case of fatal theophylline intoxication.A case of fatal poisoning caused by theophylline toxicity (serum level 127 micro g/ml) is presented. At external examination, skin blisters on regions exposed to pressure were distinctive. Histologic examination demonstrated subepidermal bullae with eosinophilic necrosis of the eccrine sweat gland coil but no epidermal necrosis, vascular changes, or inflammatory infiltrate. To the authors' knowledge, this is the first description of coma blisters in a case of theophylline intoxication.- - - - - - - - - - ranking = 1keywords = coma (Clic here for more details about this article) |
3/15. Coma blisters, peripheral neuropathy, and amitriptyline overdose: a brief report.BACKGROUND: Coma blisters are most commonly associated with barbiturate and benzodiazepine overdose; however, they have also been described in association with many other substances, including amitriptyline. OBJECTIVE: To review the literature on the clinical manifestations of coma blisters in the setting of amitriptyline overdose. methods: Case report and literature review. RESULTS: Coma blisters in association with amitriptyline overdose have rarely been documented in the literature. Of the few reported cases, peripheral neuropathy has been present two (including our case report) out of four times. CONCLUSION: amitriptyline is known to impair endothelial cell tight junction integrity. Thus, individuals with amitriptyline overdose may be predisposed to microvascular damage during the compression imposed from a comatose state. This may help to explain the tendency for patients to present with the interesting triad of coma, blisters, and neuropathy.- - - - - - - - - - ranking = 3keywords = coma (Clic here for more details about this article) |
4/15. Drug-induced sweat gland necrosis in a non-comatose patient: a case presentation.BACKGROUND: Coma-induced bullae and sweat gland necrosis is a rare clinicopathological entity often associated with drug-induced coma. SUBJECT: We report a case with clinical and histopathologic findings characteristic of blisters and sweat gland necrosis occurring in a non-comatose patient. CONCLUSIONS: skin blisters with underlying sweat gland necrosis is an entity previously reported to occur in comatose patients, our findings open new questions about the role of the drugs in the pathogenesis of those conditions.- - - - - - - - - - ranking = 7keywords = coma (Clic here for more details about this article) |
5/15. Bullous appearance of pilomatricoma.BACKGROUND: Pilomatricomas, which are usually solitary, firm to hard tumors that are covered by normal skin, rarely show a bullous appearance. OBJECTIVE: To discuss, through a case report, the clinical and histopathologic characteristics of bullous pilomatricomas. methods: A 15-year-old boy presented with a firm, well-defined tumor on his right arm that showed dark-blue discoloration and bullous formation over it. RESULTS: Excisional biopsy was performed, and histopathologic examination confirmed the diagnosis of bullous pilomatricoma. CONCLUSION: The presence of dilated lymphatics, also seen in our patient, is a common feature of bullous pilomatricomas.- - - - - - - - - - ranking = 8keywords = coma (Clic here for more details about this article) |
6/15. Bullous subacute cutaneous lupus erythematosus.We describe a 59-year-old woman, with a history of autoimmune disease and disseminated uterine leiomyosarcoma, who developed a photoaggravated, blistering skin eruption. An initial rash, at the outset of treatment with chemo- and radiotherapy, resembled erythema multiforme. review of the original skin biopsy showed it to be subacute cutaneous lupus erythematosus. There were no systemic symptoms or signs to suggest systemic lupus erythematosus. The much later photoaggravated rash consisted mainly of bullae and eventual epidermal denuding which resembled toxic epidermal necrolysis. We propose that the clinical and histological diagnosis is one of bullous subacute cutaneous lupus erythematosus in a patient with no other features of systemic lupus erythematosus.- - - - - - - - - - ranking = 1keywords = coma (Clic here for more details about this article) |
7/15. Management of intracorneal bleb after trabeculectomy for congenital glaucoma.PURPOSE: Congenital glaucoma is a well-recognized entity that can occur in the presence of anterior segment dysgenesis. trabeculectomy is an accepted intervention in the management of congenital glaucoma. The surgical technique as well as complications is well described. methods: This is a case report of a 3-month-old girl with anterior segment dysgenesis and glaucoma. She was referred post-trabeculectomy with persistent corneal opacity to be considered for penetrating keratoplasty and was found to have intrastromal corneal bleb. RESULTS: Ultrasound biomicroscopy confirmed communication of the corneal bleb with the anterior chamber, and the bleb was treated by autologous blood injection at the trabeculectomy site, under acetazolamide cover. CONCLUSIONS: We present evidence suggesting that abnormal structure was the etiologic basis for corneal bleb formation and describe our management of this previously unreported complication of trabeculectomy.- - - - - - - - - - ranking = 7keywords = coma (Clic here for more details about this article) |
8/15. Upper eyelid extension of a filtering bleb following glaucoma shunt surgery.The authors describe a case of a filtering bleb that extended into the eyelid of a 71-year-old man following glaucoma surgery with a shunt implant. The patient presented with a left upper eyelid mass and had ocular surface and mechanical sequelae. Computed tomography scan demonstrated a fistula between the original filtering tract and the eyelid, creating an inadvertent filtering bleb. Cytology revealed fluid consistent with aqueous humor. intraocular pressure remained normal and symptoms improved with conservative management. The patient deferred any surgical revision. glaucoma tube shunts may lead to ocular and rare orbital complications from inadvertent bleb extension, as seen in this case.- - - - - - - - - - ranking = 6keywords = coma (Clic here for more details about this article) |
9/15. Cutaneous bullae in coma due to poisoning. An association with deep seated ischaemic lesions of muscle.A deeply unconscious patient may develop ischaemia in those soft tissues subjected to pressure. Pressure on the skin may give rise to blistering which is reversible. Pressure on the limbs may precipitate irreversible ischaemia of the muscles and nerves unless a fasciotomy is performed.- - - - - - - - - - ranking = 4keywords = coma (Clic here for more details about this article) |
10/15. skin blisters as a manifestation of oxazepam toxicity.A 75 year-old comatous patient was admitted after ingestion of 200 mg oxazepam. skin blisters, attributed to oxazepam toxicity, appeared on the left forearm the following day and regressed spontaneously nine days later.- - - - - - - - - - ranking = 1keywords = coma (Clic here for more details about this article) |
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