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Heparin‐induced haemorrhagic bullous dermatosis
Author(s) -
Snow S. C.,
Pearson D. R.,
Fathi R.,
Alkousakis T.,
Winslow C. Y.,
Golitz L.
Publication year - 2018
Publication title -
clinical and experimental dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.587
H-Index - 78
eISSN - 1365-2230
pISSN - 0307-6938
DOI - 10.1111/ced.13327
Subject(s) - medicine , heparin , bulla (seal) , dermatology , adverse effect , surgery , lung
Summary Background Heparin‐induced haemorrhagic bullous dermatosis ( HBD ) is a rare but probably underdiagnosed reaction to heparin, with 26 cases reported in the English literature. Currently, there is no consensus regarding the treatment. Aim To assess our new cases of HBD and review the previously reported cases, in order to draw conclusions about this adverse skin reaction to heparin. Methods A PubMed search was performed for articles containing the terms ‘(heparin‐induced AND (blister OR bulla OR bullae)) OR (hemorrhagic bullous dermatosis AND heparin) OR heparin bullous dermatosis’. Descriptive statistical data analysis was performed using Microsoft Excel. Results We assessed five new cases of HBD . In addition, our literature search revealed 26 previously reported patients. Combining these, we found that the mean ± SD age of patients with HBD was 71.4 ± 14 years. HBD affects men more commonly than women (men 22/31; P = 0.02). Patients develop tense bullae most frequently on the extremities, approximately 8 days (mean ± SD 7.5 ± 6.4 days) after starting treatment with a heparin product, usually enoxaparin. Conclusions The typical clinical course is spontaneous resolution within days to weeks irrespective of continuation of heparin therapy. Because of its self‐limiting nature, interruption of heparin therapy may not be required.