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Abstract
Warfarin is a common drug used in treating patients with deep-vein thrombosis, pulmonary embolism and other conditions. One of its adverse effects is warfarin-induced skin necrosis (WISN) which is a rare complication and accounts for 0.01%–0.1% of patients who received the drug. We are reporting a 60-year-old diabetic male presented to the emergency room complaining of right leg pain and swelling. On examination, the calf muscles were tender, indurated and swelled. Laboratory tests showed elevated D-dimer. Duplex ultrasound revealed a thrombus in the popliteal and tibial veins. Heparin was started and warfarin was added after 3 days. On the next day of warfarin overlap, the whole leg and ankle become dusky blue in colour. WISN is suspected and thus warfarin is stopped, after which the patient's skin gradually improved. We are assuming that improper overlap of heparin in this case resulted in such a condition.
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