Generalized Cutaneous Necrosis: A Complication of Low-Molecular-Weight Heparin

September 2005 in “ International Wound Journal ”

Girish Khandubhai Patel, Arthur Knight

cutaneous necrosis low-molecular-weight heparin tinzaparin deep vein thrombosis heparin necrosis skin biopsy thrombophilia heparin injections histopathological findings nutritional supplements topical dressings surgical debridement skin grafts antibody-mediated thrombocytopenia LMWH DVT

TLDR A woman developed severe skin damage after using a blood thinner called low-molecular-weight heparin.

The document describes a case where a 66-year-old woman developed generalized cutaneous necrosis after being treated with low-molecular-weight heparin (LMWH), specifically tinzaparin, for a suspected deep vein thrombosis (DVT). Despite normal blood count and thrombophilia screen results, a skin biopsy confirmed the diagnosis of heparin necrosis based on the timing of heparin injections, skin symptoms, rapid progression, and histopathological findings. The patient's treatment included nutritional supplements, topical dressings, surgical debridement, and skin grafts. The case highlights the need for awareness of heparin necrosis, which can be fatal and is more common in certain adult populations. The exact cause of heparin necrosis remains unclear, but it may be related to antibody-mediated thrombocytopenia.

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