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KMID : 0948920150140020102
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Clinical Pain
2015 Volume.14 No. 2 p.102 ~ p.104
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Warfarin Induced Skin Necrosis of Toe in a Spinal Cord Injury Patient -A Case Report-
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Song Yun-Gyu
Chun Jin-Young
Kim Gi-Wook
Won Yu-Hui
Seo Jeong-Hwan
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Abstract
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Warfarin is a highly effective anticoagulant widely used for the prevention and treatment of venous thromboembolism, pulmonary thromboembolism, ischemic stroke and heart disease. Although hemorrhagic problems are well known, adverse effects associated with the use of warfarin include hepatitis, petechiae, ecchymosis, allergic reaction, purple toe syndrome, and skin necrosis. We report a patient suffering from bilateral skin necrosis of toes after taking the warfarin. A 69-year-old man was diagnosed deep vein thrombosis after incomplete C4 spinal cord injury (ASIA B). In 4 days after taking warfarin (4 mg), we found skin color change on the bilateral toes: initially purple, progressing to dark skin color and gangrene necrosis. After 42 days from onset, despite careful wound care, 2 toes were amputated. Warfarin-induced skin necrosis is a rare but serious complication. When a patient taking warfarin complains of localized skin problem, the clinician should be aware of the possibility of warfarin induced skin necrosis.
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KEYWORD
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Spinal cord injuries, Skin disease, Warfarin
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