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1 results

  • An unusual case of warfarin-induced pinna skin necrosis

  • M Martinez Del Pero, S Verma, A Espeso, M Griffiths, P Jani
  • Journal:
    The Journal of Laryngology & Otology / Volume 123 / Issue 6 / June 2009
    Published online by Cambridge University Press:
    17 October 2008, pp. 685-688
    Print publication:
    June 2009
  • Introduction:

    Warfarin-induced skin necrosis is a rare but recognised complication of this drug. The condition predominantly affects the breasts, buttocks and thighs of obese, peri-menopausal women. We present the case of a patient with the condition in an unusual site, and we discuss the management challenges involved.

    Case report:

    An 82-year-old man presented to the ENT department with a diagnosis of pinna haematoma. There was no history of trauma or infection. The patient was taking warfarin long-term for recurrent deep vein thrombosis. Two weeks prior to admission, the patient had had a loading course of warfarin following surgery. Multiple clinical teams were involved in treatment. The only abnormal laboratory investigation was a low protein S level; biopsy showed skin necrosis.

    Conclusion:

    In this case, the unusual presentation created diagnostic confusion, and may have precipitated aggressive surgical debridement. However, a more conservative management strategy was used, which we would recommend in future.