Warfarin-induced skin necrosis in HIV-1-infected patients with tuberculosis and venous thrombosis

Late onset Warfarin induced skin necrosis in human immunodeficiency virus infected patient with pulmonary tuberculosis

The incidence of Warfarin-induced skin necrosis (WISN) is very low 0.01-0.10%. The majority of the WISN cases appear between day 3 and 6 of onset of Warfarin therapy. The cases of late onset WISN are rarely seen. We report a case of late onset WISN in a young human immunodeficiency virus positive female patient with thrombotic pulmonary embolism and reactivation of pulmonary tuberculosis.

Paradoxical thrombosis, part 2: anticoagulant and antiplatelet therapy

Arterial thrombosis is the leading causes of morbidity and mortality worldwide, whereas venous thrombosis is the most common preventable cause of hospital death. In either case, venous and arterial thrombosis should be considered autonomous entities, with only minor overlaps in terms of risk factors, predisposing conditions and pathogenesis. Besides the widespread perception of embolization originating from low-pressure venous system and triggering ischemic stroke or peripheral arterial occlusion, "paradoxical" thrombosis might also develop or occur within clinical or biological circumstances where the blood should be less predisposed to clot, and wherein this risk is mostly unpredictable or overlooked. In this article we review epidemiological evidence and potential pathogenetic mechanisms of paradoxical thrombosis developing during antithrombotic therapy with vitamin K antagonists and heparin (i.e. heparin-induced thrombocytopenia), or antiplatelet agents such as aspirin, glycoprotein IIb/IIIa inhibitors or clopidogrel, and mostly attributable to direct effect of the agent.

Late onset Warfarin induced skin necrosis in human immunodeficiency virus infected patient with pulmonary tuberculosis

The incidence of Warfarin-induced skin necrosis (WISN) is very low 0.01-0.10%. The majority of the WISN cases appear between day 3 and 6 of onset of Warfarin therapy. The cases of late onset WISN are rarely seen. We report a case of late onset WISN in a young human immunodeficiency virus positive female patient with thrombotic pulmonary embolism and reactivation of pulmonary tuberculosis.

Warfarin-induced skin necrosis

Warfarin-induced skin necrosis is a rare but serious complication of treatment with this commonly prescribed drug. This lesson presents the case of a patient with extensive skin necrosis after inappropriately prolonged warfarinisation and delayed recognition. The condition is briefly reviewed to highlight key features and risk factors.