Journal of Hematology & Thromboembolic Diseases
Open Access

Jan Jacques Michiels

Publications

• Case Report
  Coumarin Induced and Spontaneous Hemorrhagic Skin Necrosis
  Author(s): Jan Jacques Michiels, Fibo Ten Kate Jan Jacques Michiels, Fibo Ten Kate
  
  Patients with coumarin induced skin necrosis presents with painful purpura and erythematous bluish swelling of the skin complicated by blister formation, hemorrhage and immanent gangrene. Coumarin induced hemorrhagic skin necrosis occurs within one week after initiation of coumarin treatment at time of prolonged INR caused by an imbalance within the vitamin K dependent anticoagulant and procoagulant factors with severe protein C and factor VII deficiency as compared to near normal factor II, X and IX. Treatment consists of vitamin K supplementation and short-term discontinuation of coumarin. Patients with pre-existing congenital protein C deficiency or acquired protein C deficiency due to vitamin K deficiency are at increased risk for the development of coumarin skin necrosis. In this report we described a case of coumarin induced hemorrhagic skin necrosis and a case of spontaneous he.. View More»
  DOI: 10.4172/2329-8790.1000257

  Abstract PDF

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