Warfarin-induced skin necrosis in a patient with a mutation of the prothrombin gene.

Abstract

To the Editor: Skin necrosis is a rare complication of warfarin therapy.1 The necrotic lesions usually appear in a distinct pattern, with a predilection for fatty tissues such as the breasts, buttocks, and thighs, three to six days after the initiation of warfarin therapy. The pathophysiology underlying warfarin-induced skin necrosis is not entirely understood. Hypercoagulability has been found in patients with necrosis and in some cases correlates with hereditary conditions such as deficiencies of protein C, protein S, and antithrombin III.2 We describe a case of warfarin-induced skin necrosis in a patient with a G20210A mutation of the prothrombin gene . . .