Shafiee MA
Royal College Mentor, Toronto General Hospital,
200 Elizabeth Street, 14 EN-208, ON, M5G 2C4, Toronto
Canada
Case Report
Late-onset Warfarin Induced Skin Necrosis: In a Hemodialysis Patient
Author(s): Shafiee MA, Akbarian F, Memon KK, Aarabi M, Shahideh Y, Johnson D and Sharif UShafiee MA, Akbarian F, Memon KK, Aarabi M, Shahideh Y, Johnson D and Sharif U
Chronic dialysis patients frequently present with necrotic skin lesions. The differential diagnoses are broad and complex. The main focus of this paper is differentiating features of two diagnostic entities: Warfarin induced skin necrosis and calciphylaxis as early recognition and treatment may prevent the significant mortality. We discuss a case involving a hemodialysis patient, who developed necrotic skin lesions over her thighs and gluteal areas shortly after restarting warfarin for atrial fibrillation without heparin bridging therapy. Incisional biopsies and pathology report were consistent with warfarin induced skin necrosis. Significant improvement of the lesions following discontinuation of Warfarin was also confirming the diagnosis of Warfarin Induced Skin Necrosis.
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