# Paradoxical coma bullae in methamphetamine use: cutaneous markers of severe rhabdomyolysis - URL: https://alisanburak.com/en/wcp-2026-posterler/ev0657 - Language: en - Last updated: not specified - Page title: Paradoxical coma bullae in methamphetamine use: cutaneous markers of severe rhabdomyolysis | WCP 2026 Summary > Coma bullae developing at pressure sites may be a visible marker of severe rhabdomyolysis and acute kidney injury due to prolonged immobility following stimula… This page was translated automatically from Turkish. [Read the original](https://alisanburak.com/wcp-2026-posterler/ev0657) Bu sayfa, 26. Dünya Psikiyatri Kongresi'nde sunulan çalışmanın yapay zekâ desteğiyle hazırlanmış Türkçe özetidir. Çalışmanın sahibi sunan yazarlardır; atıf için orijinal kaynağa başvurun. EV0657 E-PosterBağımlılıkOlgu sunumu # Paradoxical coma bullae in methamphetamine use: cutaneous markers of severe rhabdomyolysis PARADOXICAL COMA BLISTERS IN METHAMPHETAMINE USE: CUTANEOUS MARKERS OF SEVERE RHABDOMYOLYSIS Sunan: Chih-Wei Tang Ülke: Taiwan Kurum: Kaohsiung Municipal Kai-Syuan Psychiatric Hospital Coma bullae developing at pressure sites may be a visible marker of severe rhabdomyolysis and acute kidney injury due to prolonged immobility following stimulant use. The aim is to report coma bullae as a marker of rhabdomyolysis and acute kidney injury (AKI) following intravenous methamphetamine use; although stimulant intoxication typically presents with agitation, profound immobility can occur after high-intensity use. The case involves a 30-year-old man who developed necrotic bullae on his shoulder and thigh following intravenous methamphetamine use and prolonged immobility; the morphology, distribution over pressure points, and laboratory findings were evaluated with pressure-induced coma bullae, levamisole-associated vasculopathy, and necrotizing soft tissue infection considered in the differential diagnosis. Laboratory findings revealed severe rhabdomyolysis with a creatine kinase (CK) level of 15,112 U/L, acute kidney injury with a creatinine level of 2.6 mg/dL, AST predominance with AST of 385 and ALT of 167 U/L (ratio 2.31), and no neutropenia, with a white blood cell count of 12,500/uL. The authors note that AST predominance in the context of markedly elevated CK supports a muscular source, but that the ratio alone is not specific. In the diagnostic reasoning, the distribution over pressure points, prolonged immobility, and co-occurrence of rhabdomyolysis and AKI supported coma bullae; the absence of neutropenia and the classic retiform pattern involving the ears or face made levamisole-associated vasculopathy less likely. It was emphasized that necrotizing infection must be urgently ruled out in the presence of pain, a toxic appearance, rapid spread, crepitus, or imaging findings suggestive of deep infection. The working diagnosis was pressure-induced coma bullae with severe rhabdomyolysis and AKI. In conclusion, stimulant exposure does not exclude immobilization injury; because bullae at pressure sites may indicate occult muscle injury and renal risk, CK, creatinine, electrolytes, and urine output should be assessed early, rhabdomyolysis should be treated while surgical emergencies are ruled out, and the skin–muscle–kidney axis should be considered rather than immediately labeling the lesion as vasculitis or infection. [Orijinal postere git](https://cslide.ctimeetingtech.com/wcp26/attendee/eposter/file/988) Bu çalışmaya nasıl atıf yapılır? APA 7: Tang, C-W., Wang, Y-Y., Chou, F. H-C., & Chang, C-C. (2026, September 23-26). Paradoxical coma blisters in methamphetamine use: cutaneous markers of severe rhabdomyolysis [E-poster]. 26th WPA World Congress of Psychiatry (WCP 2026), Stockholm, Sweden. https://cslide.ctimeetingtech.com/wcp26/attendee/eposter/file/988 Vancouver: Tang CW, Wang YY, Chou FHC, Chang CC. Paradoxical coma blisters in methamphetamine use: cutaneous markers of severe rhabdomyolysis [e-poster]. 26th WPA World Congress of Psychiatry (WCP 2026); 2026 Sep 23-26; Stockholm, Sweden. Available from: https://cslide.ctimeetingtech.com/wcp26/attendee/eposter/file/988 Yazar adları ve başlık biçimi kongre sisteminden otomatik oluşturulmuştur; kullanmadan önce orijinal posterle karşılaştırın. ## Aynı konudan - [Kannabis kaynaklı psikotik bozuklukta yatışlar ve yeniden yatışlar: retrospektif bir kohort çalışması (2018 ile 2024 arası)](https://alisanburak.com/en/wcp-2026-posterler/ev0001) - [Bağımlılıklarda psikoplasti ve bütünleşik yönetim: ASAM ölçütleri kullanılarak ödül yolağının yeniden biçimlendirilmesine yönelik nörobiyolojik bir algoritma](https://alisanburak.com/en/wcp-2026-posterler/ev0003) - [Slovenya cezaevi hizmetinde depo buprenorfin uygulamasının başlatılması](https://alisanburak.com/en/wcp-2026-posterler/ev0004) - [Bağımlılıklarda metilfenidat: DEHB olan ve olmayan erişkinlerde madde kullanımı ve bağımlılık yapan davranışlara ilişkin gelişen kanıtlar](https://alisanburak.com/en/wcp-2026-posterler/ev0005) - [Malezya'da naltreksonun genişleyen klinik kullanım alanları: madde kullanımı ve madde dışı psikiyatrik bozukluklar açısından çıkarımlar](https://alisanburak.com/en/wcp-2026-posterler/ev0006) [Tüm WCP 2026 özetleri](https://alisanburak.com/en/wcp-2026-posterler) --- Kaynak / Source: https://alisanburak.com/en/wcp-2026-posterler/ev0657 İletişim / Contact: Bağdat Caddesi, Veli Güneysu Apt. 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