Friedenberg W R, West M, Miech D J, Mazza J J
Arch Dermatol. 1978 Apr;114(4):578-80.
A 67-year-old woman with a history of thrombophlebitis had been taking warfarin sodium for 1 1/2 years when she developed multiple skin lesions resembling warfarin-induced skin necrosis or purpura fulminans. Despite discontinuing the warfarin and administering prednisone, the lesions increased in size. Disseminated intravascular coagulation (DIC) was found and resolved with heparin sodium therapy, and her skin lesions healed. This patient was believed to have an atypical form of purpura fulminans rather than warfarin-induced skin necrosis because of the duration of warfarin therapy and the dramatic resolution with heparin. A monoclonal (IgG) gammopathy was found, which stabilized as the skin lesions resolved, and fulfilled the criteria for a benign (asymptomatic) monoclonal gammopathy.
一名有血栓性静脉炎病史的67岁女性服用华法林钠1年半后，出现了多处类似华法林所致皮肤坏死或暴发性紫癜的皮肤损害。尽管停用了华法林并给予泼尼松治疗，但损害仍增大。发现弥散性血管内凝血（DIC），经肝素钠治疗后得到缓解，其皮肤损害愈合。由于华法林治疗的持续时间以及肝素治疗后病情戏剧性缓解，该患者被认为患的是非典型暴发性紫癜而非华法林所致皮肤坏死。发现了一种单克隆（IgG）丙种球蛋白病，随着皮肤损害的缓解病情稳定，符合良性（无症状）单克隆丙种球蛋白病的标准。
