Case Of Warfarin-induced Skin Necrosis Research Articles

Mortaliteyle Sonuçlanan Geç Başlangıçlı Warfarin Kaynaklı Cilt Nekrozu Olgusu

Warfarin-induced skin necrosis is a rare complication of warfarin therapy and is associated with high mortality. Here, we present a case of warfarin-induced skin necrosis, that was fatal in a 53-year-old female patient who was started on warfarin treatment 5.5 years ago due to atrial fibrillation and previous mitral valve surgery. Patients using warfarin should be evaluated for warfarin-induced skin necrosis when they present with skin lesions. Early diagnosis, early discontinuation of the drug, early initiation of supportive treatment can be life-saving.

Anticoagulation therapy for thromboembolism prevention: a case of warfarin-induced skin necrosis in the setting of protein C deficiency

Patients with protein C deficiency are at increased risk for thrombolic diseases. Non-vitamin K antagonist anticoagulant options should be considered in patients with warfarin-induced skin necrosis (WISN) in the setting...

Warfarin Induced Skin Necrosis: A Diagnostic Challenge

Warfarin is a commonly used oral anticoagulant in the treatment of many major chronic illnesses. Early diagnosis and discontinuation of warfarin are crucial for the better prognosis. We are sharing an interesting case of warfarin-induced skin necrosis to increase physician awareness as warfarin induced skin necrosis is difficult to differentiate from some other dermatologic conditions. This case also illustrates that a high degree of suspicion combined with clinical history, laboratory findings and sometimes skin biopsy are required to make diagnosis.

Warfarin-Induced Skin Necrosis Following Heparin-Induced Thrombocytopenia

Anticoagulants, such as heparin and warfarin, are commonly used in the treatment and prevention of thromboembolic events. The risk of developing warfarin-induced skin necrosis (WISN) with warfarin is reported to be <1%. However, the risk of WISN may be increased with the initiation of warfarin in the setting of heparin-induced thrombocytopenia and thrombosis syndrome (HITT). WISN can lead to catastrophic tissue necrosis requiring amputations and mass debridement. This report describes a case of WISN following HITT and discusses the appropriate medical management of patients with HITT to avoid secondary WISN.

Warfarin-induced skin necrosis treated with protein C concentrate (human)

A case of warfarin-induced skin necrosis (WISN) treated with protein C concentrate (human) is reported. A 46-year-old Caucasian woman was admitted to the hospital for a herpes viral infection complicated by neutropenic fevers of unknown origin. Broad-spectrum antibiotics were initiated, as well as enoxaparin for prophylaxis of deep venous thrombosis. By hospital day 7, the patient's platelets decreased by 50%; by hospital day 8, they decreased another 50%. A test for heparin antibody was positive, and enoxaparin was stopped. Two days later, the patient developed a clot in her peripherally inserted central catheter, and warfarin and argatroban were initiated. Within 24 hours of warfarin initiation, the patient developed swelling in her feet and new lesions on her inner thigh, buttock, face, feet, fingers, and arms. She was treated with phytonadi-one and fresh frozen plasma, but these treatments failed to slow the progression of her lesions, which had turned to necrotic tissue. WISN was suspected, and warfarin therapy was discontinued after three doses. After a consultation with a hematologist, treatment with protein C concentrate (human) was initiated. Within 24 hours of treatment with this product, progression of necrosis stopped, and the patient's respiratory failure resolved. The patient underwent multiple skin grafts, and the lesions healed without extensive scarring. She experienced no adverse effects with the administration of protein C concentrate (human). A patient with WISN was treated with protein C concentrate (human) with overall good results and no adverse effects.

Fatal warfarin-induced skin necrosis after total hip arthroplasty

Skin necrosis associated with warfarin anticoagulation is a rare but serious complication. Few cases of warfarin-induced skin necrosis are found in the orthopaedic literature. We report a fatal case of warfarin-induced skin necrosis after total hip arthroplasty. Copyright 2002, Elsevier Science (USA). All rights reserved.

Warfarin-induced skin necrosis: an entity occasionally requiring burn wound expertise

We describe a severe case of warfarin-induced skin necrosis with extensive full-thickness tissue loss involving approximately 12 per cent of the body surface area. The early management was conservative, with wound observation only, and no agressive débridement was attempted. Wound and associated systemic sepsis followed, and the patient was transferred to our burn unit. The wounds were then managed with aggressive therapy including surgical excision, temporary coverage with allograft, and final closure with split-thickness autograft. This case illustrates important principles of appropriate surgical management of extensive skin lesions of this type.