Acenocoumarol and vasculitis: a case report.
A 62-year-old woman was referred to the dermatology department for a history of fever, asthenia and cutaneous rash, which appeared after a 3-day course of digitalin and acenocoumarol for atrial fibrillation. The physical examination revealed multiple round confluent purpuric lesions over her entire legs with no blistering. Laboratory exams were all negative. Biopsy of the involved skin was compatible with leucocytoclastic vasculitis. The acenocoumarol treatment was withheld and the skin lesions resolved spontaneously over the next 10 days. The cause of this purpura was seemingly acenocoumarol because of the close temporal relationship between exposure to the drug and the onset of the symptoms, and the spontaneous resolution of the lesions after acenocoumarol was discontinued. This observation illustrates a rare association between vasculitis and acenocoumarol. Clinicians should be aware of this potential adverse effect and recommend interrupting the drug intake when temporal relation is evocative.
Aouam
Karim
K
Service de Pharmacologie, Faculté de Médecine, Monastir, Tunisia. aouam_k@yahoo.fr
Gassab
Azza
A
Khorchani
Hassen
H
Bel Hadj Ali
Hichem
H
Amri
Montassar
M
Boughattas
Naceur A
NA
Zili
Jamel Eddine
JE
D000074:Acenocoumarol / Q000009:adverse effects* / Q000627:therapeutic use; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy; D003937:Diagnosis, Differential; D003875:Drug Eruptions / Q000175:diagnosis / Q000209:etiology; D005260:Female; D006801:Humans; D007868:Leg Dermatoses / Q000139:chemically induced* / Q000175:diagnosis; D008875:Middle Aged; D018366:Vasculitis, Leukocytoclastic, Cutaneous / Q000139:chemically induced* / Q000175:diagnosis
D000925:Anticoagulants; D000074:Acenocoumarol