Warfarin-Induced Necrosis of Skin
Authors: JEROME P. LACY
Journal: Annals of Internal Medicine (1975)

Letters1 March 1975Warfarin-Induced Necrosis of SkinJEROME P. LACY, M.D., ROBERT R. GOODIN, M.D., F.A.C.C.JEROME P. LACY, M.D.Search for more papers by this author, ROBERT R. GOODIN, M.D., F.A.C.C.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-82-3-381 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptCoumarin congeners are known to cause cutaneous lesions of a hemorrhagic type secondary to depression of vitamin K-dependent clotting factors. Nonhemorrhagic skin lesions reported to occur include urticaria, dermatitis, and the "purple toes" syndrome (1, 2). Necrosis of the skin and subcutaneous tissue has also been described and is a rare unpredictable complication whose mechanism is unknown. Most reports of coumarin necrosis have been with bishydroxycoumarin (Dicumarol®), however, sodium warfarin (Coumadin®) is now a well-documented cause (3, 4).A 64-year-old, white, female housewife was admitted to the Louisville Jewish Hospital with a 5-year history of intermittent dyspnea and chest pain....References1. SCHIFFKERN BA: Cutaneous reactions to anticoagulants. Arch Dermatol 98:136-137, 1968 CrossrefMedlineGoogle Scholar2. FEDERAUERBACH WR: "Purple toes": an uncommon sequela of oral coumarin drug therapy. Ann Intern Med 55:911-917, 1961 LinkGoogle Scholar3. KOCH-WESER J: Coumarin necrosis. Ann Intern Med 68:1365-1367, 1968 LinkGoogle Scholar4. CHUACHISCANOWUKASCH FAD: Dermal gangrene. An unpredictable complication of coumarin therapy. J Thorac Cardiovasc Surg 65:238-240, 1973 CrossrefMedlineGoogle Scholar5. DAVISWILEYFAULCONER CWR: Necrosis of the female breast complicating oral anticoagulant treatment. Ann Surg 175:647-656, 1972 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: JEROME P. LACY, M.D.; ROBERT R. GOODIN, M.D., F.A.C.C.Affiliations: Department of Cardiology University of Louisville School of Medicine Louisville, Kentucky 40202 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byDrug ReactionsJuvenile gangrenous vasculitis of the scrotum: Is it a variant of pyoderma gangrenosum?Adverse Drug Reactions: Recurrent Warfarin-Induced Skin Necrosis in a Patient with Protein S DeficiencyWarfarin-Induced Skin NecrosisWarfarin-induced complete bilateral breast necrosisCoagulopathy and warfarin-associated breast necrosis in a patient with a primary brain tumorWarfarin skin necrosis treated with prostacyclinWarfarinCoumadin-induced Skin NecrosisDermal Necrosis Following Coumarin: Is It Immunologically Induced?Warfarin skin necrosis.An unusual extracolonic manifestation of chronic ulcerative colitisDermal gangrene. A rare complication of warfarin therapyWarfarin-Induced NecrosisD. KOHN, M.D. 1 March 1975Volume 82, Issue 3Page: 381-382KeywordsCoumarinsDyspneaIschemiaLesionsNecrosisSodiumUrticaria ePublished: 1 December 2008 Issue Published: 1 March 1975 PDF downloadLoading ...