Skin Necrosis Induced by Coumarin Congeners

Fred, Herbert L.

doi:10.14503/thij-17-6430

Cited by 6 publications

(2 citation statements)

References 26 publications

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“…Skin necrosis can result from endothelial damage and microthrombi development. While coumarin does not have any anticoagulant effects by itself, it is the parent substance of congeners such as fluindione, AC (nicoumalone), bishydroxycoumarin (dicumarol), and phenprocoumon, which cause skin necrosis [ 4 ]. As a result, we will use the terminology used in prior studies [ 4 ] and refer to this disease as skin necrosis caused by coumarin congeners (SNICC).…”

Section: Discussionmentioning

confidence: 99%

“…Despite the lack of understanding of the pathogenesis of cutaneous necrosis, recent research has suggested that local and genetic factors, as well as a transient imbalance of coagulation mechanisms could play a role [ 3 ]. The most commonly used anticoagulant is WA, and most reports on anticoagulant-induced skin necrosis mention WA [ 4 ]. Cutaneous necrosis due to AC therapy is underreported in the literature.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cutaneous Necrosis Over the Nose and Lower Limbs Induced by Acenocoumarol: A Case Report and Literature Review

Alsahli¹,

Shadid²,

Al-Modayfer³

et al. 2023

Cureus

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Coumarin derivatives are the most used class of oral anticoagulants, and almost 1-2% of adults worldwide take it in the form of warfarin (WA) or acenocoumarol (AC). Cutaneous necrosis is a rare and severe complication of oral anticoagulant therapy. Most commonly, it occurs in the first 10 days, and the incidence peaks between the third and sixth day of starting treatment. Cutaneous necrosis due to AC therapy is underreported in the literature, and studies refer to this condition as "coumarin-induced skin necrosis"; however, this term is not totally accurate, as coumarin itself has no anticoagulant properties. We report a case of a 78-year-old female patient with AC-induced skin necrosis, who presented with cutaneous ecchymosis purpura over her face, arms, and lower extremities 3 hours after AC intake.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%