title: [Skin necrosis: a paradoxical complication of anticoagulation].
abstract: Skin necrosis is an uncommon complication associated with coumarin or heparin therapy. The gross appearance and histology of the lesions--a paradoxical thrombosis of skin vessels--are identical. However, skin necrosis is the symptom of two different disorders. Coumarin necrosis may be related to reduced levels of protein C or S during the early stages of anticoagulation. It is possible to continue the warfarin therapy, simultaneously with heparin, if further anticoagulation is still required. In contrast, heparin necrosis is a manifestation of the potentially fatal heparin-associated thrombocytopenia and thrombosis syndrome (HATT). Immediate discontinuation of heparin is mandatory.
authors.affiliation: Medizinische Abteilung, Ospedale della Beata Vergine, Mendrisio.
authors.forename: B
authors.initials: B
authors.lastname: Balestra
mesh_terms: D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects*; D003374:Coumarins / Q000008:administration & dosage / Q000009:adverse effects; D006493:Heparin / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D009336:Necrosis; D012867:Skin / Q000098:blood supply / Q000187:drug effects* / Q000473:pathology; D013927:Thrombosis / Q000139:chemically induced / Q000473:pathology
chemical_list: D000925:Anticoagulants; D003374:Coumarins; D006493:Heparin; C030123:coumarin