Grenier Nicole, Chen-Tsai Catherine
Department of Dermatology and Skin Surgery, Roger Williams Medical Center, Providence, RI, USA.
Int J Low Extrem Wounds. 2006 Sep;5(3):200-3. doi: 10.1177/1534734606290920.
The anticoagulant warfarin can produce a skin necrosis that is clinically indistinguishable from the skin necrosis caused by purpura fulminans associated with disseminated intravascular coagulation (DIC) and heparin-induced thrombocytopenia (HIT). The similar clinical and histologic findings observed in each of these skin necroses create a challenge for diagnosis and eventual treatment. The authors report a patient with significant risk factors for warfarin-induced skin necrosis, DIC, and HIT presenting with painful, purpuric patches beginning on her feet and extending proximally before becoming hemorrhagic bullae on her lower extremities.
抗凝剂华法林可导致皮肤坏死，在临床上与弥散性血管内凝血（DIC）及肝素诱导的血小板减少症（HIT）相关的暴发性紫癜所引起的皮肤坏死无法区分。这些皮肤坏死中每一种所观察到的相似临床和组织学表现给诊断及最终治疗带来了挑战。作者报告了一名患者，其具有华法林诱导的皮肤坏死、DIC和HIT的显著危险因素，表现为足部开始出现疼痛性紫癜斑，并向近端扩展，随后下肢出现出血性大疱。
