title: Skin necrosis due to fluindione treatment: a rare but serious complication.
abstract: In the setting of protein C deficiency, skin necrosis, which occurs most often at the initial phase of oral anticoagulants therapy, is a rare side effect. Six cases have previously been reported in the literature. In this case report, we present a protein C deficient 42-year-old woman who was being treated for venous thrombosis. Five days after the initiation of oral anticoagulant treatment, she developed extensive skin necrosis on her left calf, followed by a painful leg ulcer. The pathogenesis underlying skin necrosis caused by anticoagulation therapy is still not clear. Despite only a few cases being reported in the literature, it is important to recognise this complication since adequate therapeutic approaches leading to a stable anticoagulation state may prevent it.
authors: MD, Dermatologist, APHP, Department of Dermatology, Hospital Cochin, Paris Descartes University, Paris, France, Department of Dermatology, Ibn Sina Hospital, University of Mohammed V-Souissi, Rabat, Morocco.
authors: K
authors: K
authors: Beqqal
authors: MD, Biologist, APHP, Department of Haematology and Biology, Cochin Hospital, Paris Descartes University, Paris, France.
authors: M H
authors: MH
authors: Horellou
authors: Nurse, APHP, Department of Dermatology, Hospital Cochin, Paris Descartes University, Paris, France.
authors: A
authors: A
authors: Philippe
authors: MD, Geneticist, APHP, Department of Haematology and Biology, Georges Pompidou European Hospital, Paris, France.
authors: M
authors: M
authors: Alhene Gelas
authors: MD, Biologist, APHP, Department of Haematology and Biology, Cochin Hospital, Paris Descartes University, Paris, France.
authors: C
authors: C
authors: Flaujac
authors: MD, Dermatologist, APHP, Department of Dermatology, Hospital Cochin, Paris Descartes University, Paris, France.
authors: I
authors: I
authors: Gorin
authors: MD, Dermatologist, APHP, Department of Dermatology, Hospital Cochin, Paris Descartes University, Paris, France.
authors: S
authors: S
authors: Jacobelli
authors: MD, APHP, Department of Dermatology, Hospital Cochin, Paris Descartes University, Paris, France.
authors: N
authors: N
authors: Dupin
authors: MD, Dermatologist, Department of Dermatology, Ibn Sina Hospital, University of Mohammed V-Souissi, Rabat, Morocco.
authors: B
authors: B
authors: Hassam
authors: MD, APHP, Department of Dermatology, Hospital Cochin, Paris Descartes University, Paris, France.
authors: M F
authors: MF
authors: Avril
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000009:adverse effects*; D005260:Female; D006801:Humans; D009336:Necrosis; D009779:Occlusive Dressings; D010630:Phenindione / Q000009:adverse effects / Q000031:analogs & derivatives*; D020151:Protein C Deficiency / Q000150:complications; D020034:Silicone Gels / Q000627:therapeutic use; D012867:Skin / Q000473:pathology; D012883:Skin Ulcer / Q000139:chemically induced* / Q000628:therapy; D020246:Venous Thrombosis / Q000150:complications / Q000188:drug therapy; D014945:Wound Healing
chemical_list: D000925:Anticoagulants; D020034:Silicone Gels; D010630:Phenindione; C017673:fluindione