Warfarin-induced skin necrosis
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
Evaluation
- Clinical diagnosis
Management
- Stop warfarin
- Low molecular weight heparin or unfractionated heparin
Disposition
See Also
External Links
References
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