title: Delayed hypersensitivity reaction to subcutaneous heparin.
abstract: Two women developed well-demarcated eczematous and erythematous plaques localized to the injection sites of subcutaneous preservative-free heparin 72-96 h after heparin administration. The plaques resolved within a week of discontinuing the therapy. Neither epicutaneous testing with preservative-free heparin nor in vitro proliferation assays to heparin and two low molecular weight glycosaminoglycans could elicit a response in either patient. In contrast, both patients developed localized eczematous plaques 48-96 h after re-challenge with intradermal and/or subcutaneous heparin. Delayed hypersensitivity reactions to subcutaneous heparin are uncommon and have not been reported in the Australasian medical literature. Given the frequency with which heparin preparations are used, it is important for physicians and surgeons to be aware of this potential adverse reaction.
authors.affiliation: Sydney Melanoma Unit, Department of Surgery, Royal Prince Alfred Hospital, Camperdown, New South Wales.
authors.forename: J K
authors.initials: JK
authors.lastname: Rivers
authors.forename: M P
authors.initials: MP
authors.lastname: Gianoutsos
mesh_terms: D003875:Drug Eruptions / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D005260:Female; D006493:Heparin / Q000009:adverse effects*; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D007279:Injections, Subcutaneous; D008875:Middle Aged; D012867:Skin / Q000473:pathology
chemical_list: D006493:Heparin