Soft tissue necrosis and gangrene complicating treatment with the coumarin derivatives.
Skin and soft tissue necrosis, in association with the coumarin derivatives, characteristically afflicts females between the third and tenth days of treatment. Anatomic regions abundant in subcutaneous fat are most commonly affected. Many of these patients have underlying serious medical problems. Three additional patients with tissue infarction complicating coumadin therapy are presented. Possible etiologic mechanisms are discussed, but the basic physiopathologic condition remains an enigma. Venous thrombosis can be a related clinical phenomenon. Treatment perspectives are outlined.
D000328:Adult; D003374:Coumarins / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005734:Gangrene / Q000139:chemically induced*; D006493:Heparin / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007238:Infarction / Q000139:chemically induced; D008875:Middle Aged; D009336:Necrosis / Q000139:chemically induced*; D011655:Pulmonary Embolism / Q000188:drug therapy; D013924:Thrombophlebitis / Q000188:drug therapy; D013997:Time Factors; D014859:Warfarin / Q000009:adverse effects / Q000627:therapeutic use
D003374:Coumarins; D014859:Warfarin; D006493:Heparin