Spinal Anesthesia in a Healthy Parturient Causing Suspicious Bullous Skin Lesions: A Case Report

Author(s): Cynthia Karam, Roland Kaddoum, Nancy Abou Nafeh, Carine Zeeni, Fatima Msheik El-Khoury, Amro Khalili

We present a case of suspicious bullous skin lesions after spinal anesthesia in a previously healthy parturient presenting at term for an elective secondary cesarean section. On day 1 post-partum, pruritic red fluid-filled clustered bullae highly resembling those of bullous pemphigoid were noted around the spinal anesthesia injection site.

Fusidic acid/betamethasone skin cream was prescribed by a dermatologist for twice-daily application. The bullae decreased in size gradually and became crusted 1 week post-partum with mild residual pruritus. At 6 weeks post-partum, the bullae completely disappeared without a scar. Checking the site of neuraxial blockade on the first day postoperatively allowed early detection of such unique skin lesions.