title: Acenocoumarol and vasculitis: a case report.
abstract: 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.
authors.affiliation: Service de Pharmacologie, Faculté de Médecine, Monastir, Tunisia. aouam_k@yahoo.fr
authors.forename: Karim
authors.initials: K
authors.lastname: Aouam
authors.forename: Azza
authors.initials: A
authors.lastname: Gassab
authors.forename: Hassen
authors.initials: H
authors.lastname: Khorchani
authors.forename: Hichem
authors.initials: H
authors.lastname: Bel Hadj Ali
authors.forename: Montassar
authors.initials: M
authors.lastname: Amri
authors.forename: Naceur A
authors.initials: NA
authors.lastname: Boughattas
authors.forename: Jamel Eddine
authors.initials: JE
authors.lastname: Zili
mesh_terms: 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
chemical_list: D000925:Anticoagulants; D000074:Acenocoumarol