Disease Information for Warfarin induced subcutaneous necrosis

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Clinical Manifestations
Signs & Symptoms
Breast sore/red/inflammed/warm to touch
Erythema/rubor breast area
Annular lesions rash
Bruising/Ecchymosis
Ecchymosis, massive, flank
Expanding hemorrhagic skin necrosis/area
Painful erythema/patch breast or arms/progr. necrosis
Skin Ulcer with Eschar
Excessive/easy bruising tendency
Demographics & Risk Factors
Established Disease Population
Patient/On Medications long term/ usually
Patient/Protein C deficiency
Patient/Anticoagulated
Laboratory Tests
Abnormal Lab Findings - Decreased
Protein C level/blood (Lab)
Abnormal Lab Findings - Increased
Eosinophiles (LAB)
Diagnostic Test Results
Pathology
BX/Skin biopsy/Abnormal
BX/Skin biopsy/Fibrin clots/all vessels/necrosis
Associated Diseases & Rule outs
Rule Outs
Adenocarcinoma, breast/inflammatory
Associated Disease & Complications
Eosinophilia Hypereosinophilia
Purpura fulminans
Warfarin induced/skin necrosis
Disease Mechanism & Classification
Drugs
DRUG/Reaction to medication/drug induced (ex)
DRUG/Suppresses/Factor VII/Protein C THEN factors IX and X
DRUG/Protein C clot-inhibitor/suppressed
Pathophysiology
Pathophysiology/Gangrene/skin/subcutaneous tissue
Process
PROCESS/Complicating disorder (ex)
PROCESS/Complicating/Specific process disorder (ex)
PROCESS/Drug induced disorder (ex)
PROCESS/Necrosis (ex)
Treatment
Drug Therapy - Contraindication
RX/Warfarin (Coumadin)
Drug Therapy - Indication
RX/Anticoagulants
RX/Vitamin K
Definition

Warfarin complication with subcutaneous microthrombus; thrombophilia is triggered in certain hereditary disorders such as protein C and protein S deficincy, Leiden mutation and platelet factor III deficiency; occurs early in treatment course

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External Links Related to Warfarin induced subcutaneous necrosis
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Wikipedia
Merck
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PubMed (National Library of Medicine)
NGC (National Guideline Clearinghouse)
Medscape (eMedicine)
Harrison's Online (accessmedicine)
NEJM (The New England Journal of Medicine)
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