The diagnostic challenge of coma blisters

Coma blisters are uncommon, self-limiting skin lesions which arise in decubitus areas subjected to sustained pressure. Coma blisters are classically associated with drug-related overdose as well as a number of nondrug-related coma etiologies such as traumatic brain injury, neurologic disease, and metabolic disorders.1,2 Despite the naming convention, coma blisters can occur in varying states of alertness including stupor, lethargy, and obtundation.3 Tense blisters are the most common clinical presentation; however, coma blisters have been observed to mimic other more serious disease processes, creating a diagnostic challenge.