Dermatitis Induced by Warfarin

THE COUMARIN congeners, especially warfarin sodium, are clinically important for prolonged anticoagulation in patients with various thromboembolic disorders such as pulmonary emboli, deep venous thromboses, and arterial emboli. There is widespread clinical awareness of the hemorrhagic side effects of anticoagulation. However, the literature on the subject of coumarin-induced skin abnormalities is sparse. Report of a Case A 52-year-old real estate broker suffered his first episode of thrombophlebitis during World War II. He had several recurrences of his symptoms in the next 30 years, but did not recall having received anticoagulation therapy. On July 22, 1974, he was admitted to the hospital for pain, warmth, and swelling of his left calf. Bilateral lower extremity venograms showed extensive venous thrombi involving virtually the entire deep system and extending up to the level of the knee. The femoral vein was reconstituted, and in the midthigh, there was a persistent filling defect located medially,