Delayed warfarin induced skin necrosis in a patient with poor warfarin metabolizing activity due to interrupted warfarin therapy

摘要

Warfarin-induced skin necrosis (WISN) is a rare but potentially devastating complication of oral anticoagulation occurring within 3-10 days of warfarin therapy. Potential causes of WISN include overdose of warfarin, drugs which affect liver function, acquired or hereditary protein C, protein S or antithrombin deficiency, factor V Leiden mutation, and lupus anticoagulants [1]. The dermatologic complications occur in 0.01 to 0.1 % of warfarin-treated patients [2].