Coma Blister, Compressive Neuropathy and Rhabdomyolysis: Case Reports and Literature Review

昏迷性水泡症最早在1965被報導為急性巴比妥鹽中毒後所產生之水泡病，後續雖有爭論，但無論是藥物或非藥物引起的，在病理學上仍有一些共同的表現：(1)上皮層與真皮層分離並有水泡產生(2)皮膚附屬器官壞死，特別是汗腺管壁細胞最具有特徵。以大多數的病例來說，昏迷性水泡是自我侷限性，並不需要外科手術的介入，在此我們提出三例昏迷性水泡症病人，其在臨床表現上各有其特色與意義；其中兩例因為伴隨有壓迫性神經病變及腔室症候群，需要接受筋膜切開術以減壓併植皮覆蓋切開處。此外，在臨床上此三例病人具有不等程度的橫紋肌溶解症，其中一例甚至惡化成急性腎衰竭，必須接受血液透析，而另兩例經過支持性療法後其症狀便自我緩解。最後經由文獻回顧，將討論昏迷性水泡症與壓迫性神經病變及橫紋肌溶解症之相互關係。

關鍵字

無資料

並列摘要

Coma blister was first reported in 1965 as a bullous lesion in acute barbiturate intoxication. The etiology is debated and may be drug induced or caused by other factors. Regardless of causes, coma blisters have similar pathologic findings: epidermal-dermal separation with bullous formation and necrosis over all skin appendages, especially the sweat duct wall. In most patients, coma blisters are self-limited lesions without surgical indication. We present three cases of coma blister with diverse clinical presentations. Two patients with compartment syndrome and compressive neuropathy required fasciotomy to release the compartment pressure. Variable degrees of rhabdomyolysis were observed, and one patient developed acute renal failure requiring hemodialysis. Two other patients presented with self-limited rhabdomyolysis needing only supportive care. We review the literature on the relationship between compressive neuropathy, rhabdomyolysis, and coma blister.

並列關鍵字

coma blister ； compressive neuropathy ； rhabdomyolysis ； fasciotomy

國際替代計量

Coma Blister, Compressive Neuropathy and Rhabdomyolysis: Case Reports and Literature Review

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