Coma Blister Mimicking Necrotizing Fasciitis in a Liver Transplant Patient: A Case Report

Coma blisters (CB) are self-limiting cutaneous lesions that typically occur in patients with prolonged impaired consciousness, often due to drug overdoses such as barbiturates. They are rarely observed in liver transplant patients and can clinically mimic conditions like necrotizing fasciitis. We report the case of a 49-year-old male post-liver transplant who presented with bullous and necrotic lesions on the anterior abdominal wall, initially suspected to be necrotizing fasciitis. A skin biopsy confirmed CB, and the patient responded to corticosteroid treatment, with improvement over 20 days. The patient returned 10 months later with similar lesions, which again resolved with similar management. Early diagnosis and appropriate treatment are essential, particularly in immuno-compromised patients, to distinguish CB from more serious conditions.