Niu Mu, Deng Li-Jun, Wu Rui-Bin, Lu Zhen-Zhong
Department of Dermatology, The Fifth People's Hospital of Hainan Province, Affiliated Dermatology Hospital of Hainan Medical University, Haikou, People's Republic of China.
Department of Dermatology, Wuzhong People's Hospital, Suzhou, People's Republic of China.
Clin Cosmet Investig Dermatol. 2023 Jul 18;16:1857-1864. doi: 10.2147/CCID.S418477. eCollection 2023.
We present the first case of coma bullae observed in a 67-year-old woman due to pressure and ischemia associated with brachioradial artery. A skin biopsy taken from the ulcer border revealed extensive loss of the epidermis, fibrosis of dermis, mild infiltration by lymphocytes and neutrophils, and necrosis of the focal eccrine ducts. CT angiography of the right upper limb showed a high origin of the radial artery, meanwhile both high originating radial artery and the anastomoses were tortuous and were of relatively small caliber. The diagnosis of coma bullae was made. After tissue debridement, the skin lesions gradually recovered, leaving atrophic scars.
我们报告了首例在一名67岁女性中观察到的因肱桡动脉受压和缺血导致的昏迷大疱。从溃疡边缘取的皮肤活检显示表皮广泛缺失、真皮纤维化、淋巴细胞和中性粒细胞轻度浸润以及局灶性小汗腺导管坏死。右上肢体层CT血管造影显示桡动脉高位起源，同时高位起源的桡动脉及其吻合支均迂曲且管径相对较小。作出了昏迷大疱的诊断。组织清创后，皮肤病变逐渐恢复，留下萎缩性瘢痕。
