Late onset warfarin-induced skin necrosis.

G Ital Dermatol Venereol

Department of Dermatology, Zhongshan Hospital, Fudan University, Shanghai, China -

Published: April 2019

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Article Synopsis
  • Calciphylaxis is a serious condition associated with end-stage renal disease (ESRD), often occurring in patients on hemodialysis, where calcium builds up in small blood vessels causing pain and reduced blood flow.
  • The disease typically affects fatty areas of the body, like the abdomen, but can appear on any skin surface, including rare locations like the genital region.
  • A case study of a 53-year-old man with ESRD and painful lesions on the glans penis illustrates the quick deterioration of calciphylaxis and the challenges in treating this uncommon condition.
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Limb Ischemic Necrosis Secondary to Microvascular Thrombosis: A Brief Historical Review.

Semin Thromb Hemost

July 2024

Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada.

Ischemic limb injury can be broadly classified into arterial (absent pulses) and venous/microvascular (detectable pulses); the latter can be divided into two overlapping disorders-venous limb gangrene (VLG) and symmetrical peripheral gangrene (SPG). Both VLG and SPG feature predominant acral (distal) extremity ischemic necrosis, although in some instances, concomitant nonacral ischemia/skin necrosis occurs. Historically, for coagulopathic disorders with prominent nonacral ischemic necrosis, clinician-scientists implicated depletion of natural anticoagulants, especially involving the protein C (PC) system.

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Calciphylaxis is a rare and severe medical condition characterized by the calcification of small blood vessels and soft tissues, leading to tissue damage, skin ulcers, and intense pain. It most commonly affects individuals with underlying health conditions such as kidney disease, particularly end-stage renal disease (ESRD), and is associated with high mortality rates. Understanding the diagnosis and management of calciphylaxis is crucial for improving patient outcomes.

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Cutaneous small vessel leukocytoclastic vasculitis (LCV) is isolated to the dependent areas of the skin. LCV can be induced by pharmaceutical drugs, and management requires abrupt discontinuation of the offending drug. Warfarin is a rare medication to cause LCV, with sparse literature to date.

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Calciphylaxis, or calcific uremic arteriolopathy, is a rare and deadly disease that affects patients with end-stage renal disease (ESRD). It typically manifests in the abdomen and lower extremities. We present a case of a 59-year-old female patient on dialysis due to ESRD who complained of a three-week history of hemorrhagic and painful bilateral lower limb lesions.

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