This may lead to a transient hypercoagulable state (which is the pathophysiology underlying warfarin-induced skin necrosis)
A 47-year-old male on life-long anticoagulation omits his medication and develops extensive skin necrosis of the left leg complicated by acute renal failure three days after restarting warfarin
See more Warfarin-induced skin necrosis (WISN) is a rare condition thought to be due to microvascular thrombosis and ischemia and is commonly related to protein C deficiency
The general progression of warfarin-induced skin necrosis is as follows: pain and erythema; petechial hemorrhages; red, purple, blue, or black discoloration;
Herein, we review the clinical and histologic features helpful for differentiating warfarin-induced skin necrosis and report a case illustrative of the diagnostic difficulty that may at times be encountered in clinical
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Her INR was 2
Skin necrosis is a rare albeit severe complication of warfarin use for anticoagulation, resulting in significant morbidity and mortality
1% of patients taking the anticoagulant and more than 300 cases have been reported
Cutaneous findings include petechiae that progress to ecchymoses and hemorrhagic bullae
Abstract
Because it is a rare effect with an undetermined pathophysiology of disease, the treatment is not well Background: Warfarin induced skin necrosis is a rare complication with a prevalence of 0
Results: There are several adverse skin manifestations associated with the use of oral
3 An acquired deficiency of protein S secondary to the development of antiphospholipid antibodies has also been
Protein C deficiency is associated with a small percentage of cases of inherited thrombophilia, as well as the even more uncommon findings of warfarin-induced skin necrosis and neonatal purpura fulminans
Results: Presentation
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of print: [please include Day
A high index of suspicion is required for diagnosis and Warfarin-induced skin necrosis, although rare (<0
Rarely, skin necrosis occurs when the resultant initial procoagulant state in the first few days of starting coumadin
The lesions of warfarin-induced skin necrosis may be difficult to differentiate from mimickers, but skin biopsy in conjunction with careful consideration of the clinical history, including time of onset, cutaneous distribution of the lesions, and laboratory findings, are essential for prompt diagnosis and patient treatment
Early recognition is imperative in diagnosis and management of sudden gangrenous changes in the skin
Cardiac auscultation showed irregular rhythm
It typically occurs within the first few days of starting warfarin [ 3 ]