Adya Keshavmurthy A, Inamadar Arun C, Palit Aparna
Department of Dermatology, Venereology and Leprosy, Shri B. M. Patil Medical College, Hospital and Research Center, BLDE University, Vijayapur, Karnataka, India.
Indian J Dermatol Venereol Leprol. 2016 Nov-Dec;82(6):626-640. doi: 10.4103/0378-6323.184199.
Anticoagulants are the cornerstone of treatment of venous thromboembolism associated with various medical conditions and surgical procedures. They act on different steps of the coagulation pathway and are broadly categorized into heparins, vitamin K antagonists, and inhibitors of thrombin and factor Xa. The classification is evolving as newer and better oral and parenteral anticoagulants are being added. Anticoagulants in dermatology are important not only for their therapeutic application in cutaneous thrombotic dermatoses such as livedoid vasculitis, purpura fulminans, superficial and deep venous thrombosis and others but also for their use in non-thrombotic dermatoses such as lichen planus, recurrent oral aphthosis, chronic urticaria and several others. Further, the use of anticoagulants for any indication is associated with various adverse effects with dermatologic manifestations including specific reactions such as warfarin-induced skin necrosis, heparin-induced thrombocytopenia and anticoagulant-associated cholesterol embolization syndrome.
抗凝剂是治疗与各种医疗状况和外科手术相关的静脉血栓栓塞的基石。它们作用于凝血途径的不同步骤，大致可分为肝素、维生素K拮抗剂、凝血酶抑制剂和Xa因子抑制剂。随着更新、更好的口服和胃肠外抗凝剂不断涌现，这一分类也在不断演变。抗凝剂在皮肤科不仅对于治疗诸如类脂质渐进性坏死性血管炎、暴发性紫癜、浅静脉和深静脉血栓形成等皮肤血栓性皮肤病具有重要意义，而且在治疗诸如扁平苔藓、复发性口腔溃疡、慢性荨麻疹等非血栓性皮肤病中也有应用。此外，无论用于何种适应症，抗凝剂的使用都与各种具有皮肤表现的不良反应相关，包括华法林诱导的皮肤坏死、肝素诱导的血小板减少症以及抗凝剂相关的胆固醇栓塞综合征等特定反应。
