Warfarin-induced skin necrosis: Difference between revisions
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==Background== | ==Background== | ||
*Differing half-lives of Vitamin-K dependent coagulation factors leads to relative protein C deficiency initially→ hypercoagulability | *Differing half-lives of Vitamin-K dependent coagulation factors leads to relative protein C deficiency initially→ hypercoagulability | ||
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==Clinical Features== | ==Clinical Features== | ||
[[File:Right leg affected by warfarin necrosis.png|thumb|Right leg affected by warfarin necrosis.]] | |||
[[File:WarfarinNecrosis.png|thumb]] | |||
*Painful, red [[rash|lesions]] over extremities, trunk, penis | *Painful, red [[rash|lesions]] over extremities, trunk, penis | ||
*Start with erythematous macule→ edema→ central purpuric zones → necrosis | *Start with erythematous macule→ edema→ central purpuric zones → necrosis | ||
Latest revision as of 20:56, 8 September 2020
Background
- Differing half-lives of Vitamin-K dependent coagulation factors leads to relative protein C deficiency initially→ hypercoagulability
- Onset usually in first week of starting warfarin
Clinical Features
- Painful, red lesions over extremities, trunk, penis
- Start with erythematous macule→ edema→ central purpuric zones → necrosis
Differential Diagnosis
Necrotizing rashes
- Necrotizing soft tissue infections
- Purpura fulminans
- Drug rash
- Levamisole toxicity
- Heparin-induced skin necrosis
- Warfarin-induced skin necrosis
Evaluation
- Clinical diagnosis
Management
- Stop warfarin
- Low molecular weight heparin or unfractionated heparin