[Recurrent pyoderma gangrenosum-like ulcers induced by oral anticoagulants]. / Ulcérations récidivantes à type de pyoderma grangrenosum induites par les antivitamines K.
Ann Dermatol Venereol
; 141(1): 34-8, 2014 Jan.
Article
em Fr
| MEDLINE
| ID: mdl-24461092
ABSTRACT
BACKGROUND:
Other than the classic skin necrosis induced by oral anticoagulants (OAC) in patients with protein C and S deficiencies, other types of OAC induced-skin ulcers are little known. Herein, we describe an original case of recurrent pyoderma gangrenosum (PG)-like ulcers induced by OAC. PATIENTS ANDMETHODS:
A 70-year-old female heart-transplant recipient presented deep, hyperalgesic and quickly-spreading necrotic ulceration of the right leg 6 weeks after starting oral anticoagulant therapy with fluindione. Histological analysis revealed dermal infiltrate containing polynuclear neutrophils, which accords with the histopathological diagnosis of leukocytoclastic vasculitis or PG. Infectious, autoimmune and thrombophilic causes were ruled out. Fluindione was withdrawn and the ulcer healed completely within a month. Six months later, right leg ulceration recurred two weeks after the patient resumed fluindione but healed within 1 month of discontinuation of the drug. An OAC from another chemical family (warfarin) was then introduced, with further recurrence of ulceration after 2 weeks of treatment.DISCUSSION:
The chronology of events and the negativity of aetiological explorations allowed a diagnosis to be made of OAC-induced skin ulcer, a rare complication of which the pathophysiology is unclear. This is the first case of PG-like ulcers induced by OAC.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Fenindiona
/
Complicações Pós-Operatórias
/
Úlcera Cutânea
/
Varfarina
/
Pioderma Gangrenoso
/
Toxidermias
/
Anticoagulantes
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
Limite:
Aged
/
Female
/
Humans
Idioma:
Fr
Revista:
Ann Dermatol Venereol
Ano de publicação:
2014
Tipo de documento:
Article