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Emergency: requires immediate attention
Coumadin necrosis
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Emergency: requires immediate attention

Coumadin necrosis

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Contributors: Noah Craft MD, PhD, Lindy P. Fox MD, Lowell A. Goldsmith MD, MPH
Other Resources UpToDate PubMed

Synopsis

Coumadin necrosis (warfarin necrosis) is a rare but serious complication of Coumadin (warfarin) therapy. Patients receiving loading doses of Coumadin develop a transient hypercoagulable state resulting in thrombosis of small cutaneous vessels eventuating in infarction and subsequent necrosis of the skin. If extensive, the condition can be fatal. Approximately 1 of 10 000 patients who receive Coumadin develop this reaction. Some patients have an associated protein C or S deficiency. Females are affected more often than males. Once necrosis has occurred, the continued use of Coumadin does not seem to cause further lesions to develop. Lesions heal by granulation over weeks.

Codes

ICD10CM:
D68.32 – Hemorrhagic disorder due to extrinsic circulating anticoagulants

SNOMEDCT:
403659005 – Coumarin necrosis

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Updated: 09/06/2017
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Emergency: requires immediate attention
Coumadin necrosis
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Coumadin necrosis : Abdomen, Coumadin, Gangrene, Painful skin lesions, Thigh, Ecchymosis
Clinical image of Coumadin necrosis
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