(1) Department of Surgery, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi 110029, India
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Introduction
Warfarin-induced skin necrosis is a rare but catastrophic complication of warfarin therapy, ranging in prevalence from 0.01% to 0.1%. This case report discusses a case of warfarininduced skin necrosis.
Case report
We report the case of an obese, 55-year-old woman who presented with extensive skin necrosis of the left lower limb on the fifth day of warfarin therapy and responded well with early diagnosis and treatment.
Discussion
Warfarin-induced skin necrosis is the result of a relatively hyper-coagulable state produced by warfarin. Warfarin-induced skin necrosis typically occurs in obese, perimenopausal women of around 50 years of age with high loading doses of warfarin. Warfarin-induced skin necrosis typically involves skin and subcutaneous tissue overlying areas with significant adipose tissue, such as the breast, abdomen, thigh or buttocks. It presents within three to six days after beginning therapy.
Conclusion
Prevention and management of warfarin-induced skin necrosis in a timely manner should be emphasised to prevent permanent tissue damage. A more gradual approach using low initial dose and gradual increase in daily doses is believed to reduce the risk of warfarin-induced skin necrosis.
