Premium
Warfarin skin necrosis: Recurrence in the absence of anticoagulant therapy
Author(s) -
Humphries John E.,
Gardner James H.,
Connelly Julia E.
Publication year - 1991
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.2830370313
Subject(s) - warfarin , medicine , necrosis , anticoagulant , thrombus , surgery , anticoagulant therapy , complication , disseminated intravascular coagulation , atrial fibrillation
Skin necrosis is a well‐known yet rare complication of oral anticoagulant therapy. We report the unusual recurrence of lesions typical of warfarin skin necrosis in the absence of anticoagulant therapy. A 59‐year‐old woman developed skin necrosis while receiving prophylactic warfarin following the detection of a large left ventricular thrombus. The warfarin was discontinued and the lesions improved. One month later new areas of skin necrosis developed although the patient had received no further warfarin. Progressive congestive heart failure, poor nutrition, and prolonged oral antibiotic therapy preceded the recurrence. Vitamin K deficiency was present on admission. The potential role of vitamin K‐dependent coagulation factors in the pathogenesis of anticoagulant‐associated skin necrosis is discussed.