Bullous haemorrhagic dermatitis induced by heparins and other anticoagulants: 94 cases from French pharmacovigilance centres and a literature review

Mu, Martin; Lambert, Aude; Miremont, Ghada; A, Gaiffe; Ms, Agier; Studer, M.; Mahé, A.; Tebacher, Martine; Cribier, B.

doi:10.1016/j.annder.2021.05.003

Cited by 9 publications

(5 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One HBHD patient with severe hemorrhagic rupture experienced BHD recurrence after a reintroduction of enoxaparin [18]. Te continued use of heparin may be a risk factor for the severity of BHD [20][21][22]. Nevertheless, further research is needed to determine which conditions can still be treated with heparin and which ones that heparin needs to be discontinued.…”

Section: Discussionmentioning

confidence: 99%

Clinical Features, Diagnosis, Treatment, and Prognosis of Heparin-Induced Bullous Hemorrhagic Dermatosis

Li,

Peng,

Zhang

et al. 2024

Dermatologic Therapy

View full text Add to dashboard Cite

Background. Heparin-induced bullous hemorrhagic dermatosis (HBHD) is a rare cutaneous adverse effect of heparin and has unclear clinical features. We explored the clinical features of HBHD to provide evidence for the safe use of heparin. Methods. We collected HBHD-related case reports for a retrospective analysis by searching the Chinese and English databases from inception to December 31, 2022. Results. Seventy-two patients, including 51 males (70.8%), were included, and they had a median age of 71.5 years (range: 21, 94). Low-molecular-weight heparin was used in 62 patients (86.1%), and unfractionated heparin was used in 10 patients (13.9%). The median time for HBHD to appear was 7 days (range: 0.25, 270). Lesions appeared far from the injection site, and the extremities (57 patients, 79.2%) were the most frequently involved site. The blisters were mainly located in the intraepidermal (34 patients, 47.2%), subcorneal (10 patients, 13.9%), and subepidermal (9 patients, 12.5%) regions. Thirty-seven patients (51.4%) had no obvious dermal inflammatory infiltration, and 20 patients (27.8%) had lymphocytic inflammatory infiltration. Sixty-seven patients (93.1%) recovered from their skin lesions after the discontinuation of heparin or despite continuing heparin and at a median treatment time of 14 days (range: 2, 141). Conclusion. HBHD is a rare self-limiting disease that occurs far from the injection site. Clinicians should be aware of BHD during the administration of heparin. Heparin can be discontinued or continued depending on the patient’s condition.

show abstract

Section: Discussionmentioning

confidence: 99%

Clinical Features, Diagnosis, Treatment, and Prognosis of Heparin-Induced Bullous Hemorrhagic Dermatosis

Li,

Peng,

Zhang

et al. 2024

Dermatologic Therapy

View full text Add to dashboard Cite

show abstract

“…Commonly reported risk factors for HIBD include advanced age, male gender, underlying chronic conditions such as cardiovascular diseases and malignancies, and prior cutaneous reactions to heparin [ 4 ]. The patient in this case, although female, aligns with the risk factor of advanced age and had underlying chronic conditions (hypertension and Alzheimer’s disease).…”

Section: Discussionmentioning

confidence: 99%

“…Clinically, this condition presents with hemorrhagic bullae that typically appear 5-21 days after the initiation of heparin therapy [ 3 ]. These lesions are usually asymptomatic and are most commonly found on the extremities and trunk [ 4 ]. Histopathological examination of biopsy samples generally reveals intraepidermal or subepidermal hemorrhagic blisters filled with red blood cells, without significant inflammatory infiltrate [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Heparin-Induced Hemorrhagic Bullous Dermatosis: A Rare Complication of Unfractionated Heparin

Zakar,

Saad,

El Tannoury

et al. 2024

Cureus

View full text Add to dashboard Cite

“…To date, there is no definitive treatment for BHD. In a study done by Uceda-Martin et al among 33 cases, the bullous lesions disappeared after stopping heparin treatment, with a mean time to resolution of 12.7±8.4 days [ 8 ]. However, in some severe cases, steroid therapy can be considered for the resolution of the lesions if there are concomitant bullous pemphigoid lesions [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Bullous Hemorrhagic Dermatosis: A Rare Benign Cutaneous Complication of Low-Molecular-Weight Heparin

Choudhury¹,

Thokchom²,

Jain³

et al. 2022

Cureus

View full text Add to dashboard Cite

Enoxaparin-mediated bullous hemorrhagic dermatosis (BHD) is one of the rare side effects during prophylaxis of enoxaparin for various thromboembolic events. We report a case of a 74-year-old female with multiple comorbidities who developed BHD at a distant site from subcutaneous delivery of enoxaparin. Histopathological analysis confirmed the diagnosis of BHD. Discontinuation of enoxaparin resulted in the gradual resolution of the bullae formation, and the patient was started on novel oral anticoagulation with apixaban. The usual cutaneous adverse effects of enoxaparin include maculopapular rash, pruritus, skin necrosis, eczematous dermatitis, and rarely bullous hemorrhagic dermatosis. This hemorrhagic bullae dermatosis at a distant site from the administration is a relatively rare and benign side effect of enoxaparin which is an under-recognized complication of low-molecular-weight heparin.

show abstract

Bullous haemorrhagic dermatitis induced by heparins and other anticoagulants: 94 cases from French pharmacovigilance centres and a literature review

Cited by 9 publications

References 37 publications

Clinical Features, Diagnosis, Treatment, and Prognosis of Heparin-Induced Bullous Hemorrhagic Dermatosis

Clinical Features, Diagnosis, Treatment, and Prognosis of Heparin-Induced Bullous Hemorrhagic Dermatosis

Heparin-Induced Hemorrhagic Bullous Dermatosis: A Rare Complication of Unfractionated Heparin

Bullous Hemorrhagic Dermatosis: A Rare Benign Cutaneous Complication of Low-Molecular-Weight Heparin

Contact Info

Product

Resources

About