title: Warfarin-induced skin necrosis.
abstract: Warfarin-induced skin necrosis is an infrequent complication occurring in individuals under warfarin treatment who have a thrombophilic history or after administration of large loading doses of warfarin particularly without simultaneous initial use of heparin. A 62-year-old lady developed skin necrosis 4 days after initiating warfarin therapy of 5 mg daily without initial co-administration of heparin. The patient had a normal clotting profile. Skin necrosis progressed to eschar formation after cessation of warfarin and heparinization stopped expanding. Warfarin was reintroduced at 2 mg daily, initially together with low molecular weight heparin. Autolytic debridement of the necrotic tissue was followed by healing of the cutaneous deficit by secondary intention. Prompt diagnosis and discontinuation of warfarin are crucial for the prognosis.
authors.affiliation: Department of Surgery-Plastic Surgery, Democritus University of Thrace, Alexandoupolis, Greece.
authors.forename: Despoina D
authors.initials: DD
authors.lastname: Kakagia
authors.affiliation: Department of Internal Medicine, Democritus University of Thrace, Alexandoupolis, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Papanas
authors.affiliation: Department of Orthopedics, Red Cross Hospital, Athens, Greece.
authors.forename: Efthimios
authors.initials: E
authors.lastname: Karadimas
authors.affiliation: Department of Surgery-Plastic Surgery, Democritus University of Thrace, Alexandoupolis, Greece.
authors.forename: Alexandros
authors.initials: A
authors.lastname: Polychronidis
keywords: Anticoagulants; Necrotic lesions; Warfarin