Bullous hemorrhagic dermatosis due to enoxaparin use in a bullous pemphigoid patient
10.5415/apallergy.2017.7.2.97
- Author:
Ji Su SHIM
1
;
Soo Jie CHUNG
;
Byung Keun KIM
;
Sae Hoon KIM
;
Kyu Sang LEE
;
Yeonyee E YOON
;
Yoon Seok CHANG
Author Information
1. Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, Korea. addchang@snu.ac.kr
- Publication Type:Case Report
- Keywords:
Hypersensitivity;
Bullous dermatoses;
Enoxaparin;
Heparin, low-molecular-weight
- MeSH:
Aortic Valve;
Drug-Induced Liver Injury;
Eczema;
Enoxaparin;
Erythema;
Hemorrhage;
Heparin;
Heparin, Low-Molecular-Weight;
Humans;
Hypersensitivity;
Korea;
Osteoporosis;
Pemphigoid, Bullous;
Prostheses and Implants;
Skin;
Skin Diseases;
Skin Diseases, Vesiculobullous;
Thrombocytopenia;
Thrombosis;
Transcutaneous Electric Nerve Stimulation;
Urticaria
- From:
Asia Pacific Allergy
2017;7(2):97-101
- CountryRepublic of Korea
- Language:English
-
Abstract:
Adverse reactions of subcutaneous low molecular weight heparin or unfractionated heparin could be complications by bleeding, heparin-induced thrombocytopenia, drug-induced liver injury, osteoporosis, and cutaneous reactions. Heparin-induced skin lesions vary from allergic reactions like erythema, urticaria, eczema to intradermal microvascular thrombosis associated with heparin-induced thrombocytopenia. There is a rare cutaneous complication, called bullous hemorrhagic dermatosis. We experienced this rare case of the cutaneous complication caused by enoxaparin. Several tense bullous hemorrhagic lesions occurred after 3 days of enoxaparin in a known bullous pemphigoid patient who had aortic valve replacement surgery with a mechanical prosthesis. The bullous hemorrhagic lesions were regressed after the discontinuation of enoxaparin but recurred after re-administration. The lesions were controlled by the administration of systemic corticosteroid and alternative anticoagulant. To date, less than 20 cases have been reported worldwide. This is the first case of bullous hemorrhagic dermatosis induced by enoxaparin, a low-molecular-weight heparin in Korea. This is also the first case of bullous hemorrhagic dermatosis in a known bullous pemphigoid patient.
