A case of warfarin skin necrosis despite enoxaparin anticoagulation in a patient with protein S deficiency

Annals of Vascular Surgery
Chau Y TaiJames B Alexander

Abstract

Warfarin-induced skin necrosis is a rare complication associated with the use of oral anticoagulants. Most patients develop this at the initiation of therapy, often while still receiving intravenous unfractionated heparin (UFH). Recently, low-molecular-weight heparins (LMWHs) have gained wider use, providing an option for outpatient treatment of deep-vein thrombosis. The treatment protocols are similar to UFH, including the early initiation of oral anticoagulation with warfarin. A Medline search failed to reveal any cases of warfarin-induced skin necrosis while using a LMWH. We present a patient with protein S deficiency who developed warfarin skin necrosis despite appropriate anticoagulation with enoxaparin, and review the chemical and clinical difference between UFH and LMWH.

References

Jul 1, 1991·American Journal of Hematology·J E HumphriesJ E Connelly
Feb 1, 1995·Annals of Plastic Surgery·A J DeFranzoL C Argenta
Jun 1, 1996·American Journal of Hematology·A P Jillella, C L Lutcher
Jun 2, 1998·The Annals of Pharmacotherapy·P Martineau, N Tawil
Jan 19, 1999·Archives of Internal Medicine·M A CrowtherJ Hirsh
Dec 1, 1998·The Physician and Sportsmedicine·K G Harmon, M B Roush

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Citations

Oct 18, 2008·The Journal of Laryngology and Otology·M Martinez Del PeroP Jani
Nov 16, 2010·The Surgical Clinics of North America·Jaymie Panuncialman, Vincent Falanga
Jul 21, 2009·Journal of the American Academy of Dermatology·Rosalynn M NazarianLyn M Duncan
Sep 8, 2017·Texas Heart Institute Journal·Herbert L Fred
Jul 23, 2014·JBJS Case Connector·Jonathan WangGavin Pereira

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