A Case of Coma Bullae Associated with Brachioradial Artery

Mu Niu,1,* Li-Jun Deng,2,* Rui-Bin Wu,2 Zhen-Zhong Lu2 1Department of Dermatology, The Fifth People’s Hospital of Hainan Province, Affiliated Dermatology Hospital of Hainan Medical University, Haikou, People’s Republic of China; 2Department of Dermatology, Wuzhong People’s Hospital, Suzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Rui-Bin Wu; Zhen-Zhong Lu, Wuzhong People’s Hospital, Suzhou, People’s Republic of China, Email wrb1968@163.com; enigmaago@163.comAbstract: 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.Keywords: coma bullae, brachioradial artery