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March 3, 1969, Vol 207, No. 9 >
ARTICLE | March 3, 1969

Carbon Monoxide and Dermal Changes

H. Ippen, MD; G. Goerz, MD
JAMA. 1969;207(9):1718. doi:10.1001/jama.1969.03150220134030.
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To the Editor:—  In Long's article about dermal changes associated with carbon monoxide intoxication (205:50, 1968), morphology, course, and histologic manifestations correspond completely to the skin lesions, which can also be seen after barbiturate intoxication and following protracted unconsciousness due to other causes or long-continued narcosis. This is not a matter of some specific effect of barbiturate or carbon monoxide on the skin. These are single decubital lesions resulting from long-continued hypoxemia due to compression.Therefore erythema, edema, bullous lesions, and eschar formation can only be found on those parts of the body which were compressed by the position of the patient.In all our cases we were able to account easily for each lesion—of one ear, on the head, arm, both knees, or the heels—as corresponding simply to pressure areas. Precondition for the origin of these lesions is consequently not some kind of a poison but only the

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