Late-onset Warfarin Induced Skin Necrosis: In a Hemodialysis Patient
2017
Chronic dialysis patients frequently present with necrotic skin lesions. The differential diagnoses are broad and
complex. The main focus of this paper is differentiating features of two diagnostic entities: Warfarin induced skin
necrosis and calciphylaxis as early recognition and treatment may prevent the significant mortality. We discuss a
case involving a hemodialysis patient, who developed necrotic skin lesions over her thighs and gluteal areas shortly
after restarting warfarin for atrial fibrillation without heparin bridging therapy. Incisional biopsies and pathology report
were consistent with warfarin induced skin necrosis. Significant improvement of the lesions following discontinuation
of Warfarin was also confirming the diagnosis of Warfarin Induced Skin Necrosis.
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