Abstract

Skin necrosis is a rare but serious complication of warfarin. A 68-year-old male patient was admitted with sudden chest pain,breathlessness and swelling of the left leg.The chest CT angiography showed thrombus both in the lower lobe pulmonary artery and its branches. Heparin and warfarin was administered. After a time,warfarin application was continued. Palpable petechiae and purpura developed the left leg and the knee in the 5th month of the treatment. Meanwhile,it was learned the patient had taken ibuprofen for 2 days before the development of the skin lesions. The examination showed that the patient had necrotic bullae on a dark erythhematous surface around the front of the right leg tibia. Skin necrosis was thought to be due to warfarin, and warfarin was stopped. Enoxaparin was initiated. Because the skin lesions did not improve,rivaroxaban treatment was started,and lesions eventually disappeared. Skin lesions should be evaluated with care in patients taking warfarin.

Key Words: Skin Necrosis; Warfarin; Rivaroxaban; Enoxaparin.