A case of unilateral purple toes due to warfarin

Al‐Niaimi, Firas; Clark, Christine

doi:10.1111/j.1365-2230.2008.02977.x

Cited by 9 publications

(4 citation statements)

References 5 publications

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“…Associated symptoms can include a burning pain and intermittent numbness. 11,12,[42][43][44] In addition to the toes, this phenomenon has also been observed in the fingertips and palms. 11,12 The mechanism contributing to WIPTS is still speculative.…”

Section: Warfarin-induced Purple Toe Syndromementioning

confidence: 83%

“…WIPTS can develop within 2 to 16 weeks after warfarin initiation, but there have been reports of a delayed onset of over a year after commencing warfarin therapy. 11,12,[42][43][44] WIPTS is often characterised by a sudden onset of a purple discoloration of the toes and sides of the feet that blanch with pressure. For the most part, the skin is intact, nonulcerated, and cool on palpation.…”

Section: Warfarin-induced Purple Toe Syndromementioning

confidence: 99%

“…Earlier case reports suggested warfarin had direct toxic effect on the capillaries, whereas more recent reports suggest it is due to cholesterol crystal embolization. [42][43][44] The current theory is that warfarin causes the embolization of cholesterol crystals from atherosclerotic plaques in the large arteries, which dislodge into the small vessels of the toes and fingers. The embolus causes vessel occlusion and ischemia.…”

Section: Warfarin-induced Purple Toe Syndromementioning

confidence: 99%

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Adverse Drug Reactions and Cutaneous Manifestations Associated With Anticoagulation

Gooderham

2017

J Cutan Med Surg

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Anticoagulants are amongst the most commonly prescribed medications worldwide. Although rare, localised and systemic drug reactions have been reported with anticoagulants that can lead to significant morbidity and mortality. Some of the first signs of drug reactions to anticoagulants are cutaneous changes that, when recognised early, can prevent significant complications. Dermatologists should be aware of these changes to make an early and accurate diagnosis. This is particularly important in instances of skin-induced necrosis caused by systemic toxicity to anticoagulants. This review discusses adverse drug reactions to the traditional anticoagulants, warfarin and heparin, and the newer direct oral anticoagulants (DOACs) such as the thrombin inhibitor, dabigatran, and the factor Xa inhibitors, rivaroxaban, apixaban, and edoxaban. In particular, this review provides dermatologists with a framework for early diagnosis and management of patients with drug reactions to anticoagulants and alerts them to potential bleeding complications associated with minor procedures.

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Section: Warfarin-induced Purple Toe Syndromementioning

confidence: 83%

Section: Warfarin-induced Purple Toe Syndromementioning

confidence: 99%

Section: Warfarin-induced Purple Toe Syndromementioning

confidence: 99%

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Adverse Drug Reactions and Cutaneous Manifestations Associated With Anticoagulation

Gooderham

2017

J Cutan Med Surg

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“…There are few reports published of this effect, and when reported, occurs relatively quickly after starting warfarin. [1][2][3][4][5][6][7][8][9][10] In addition, it is unclear, based on these reports, what therapy should be used in patients needing continued anticoagulation. We encountered an unusual case of purple toes associated with warfarin, first noticed more than 1 year after a second course of warfarin therapy, which was successfully treated with fondaparinux substitution.…”

Section: Introductionmentioning

confidence: 99%

Late Onset Purple Toe Syndrome With Warfarin Successfully Treated With Fondaparinux

Rindone

Mellen²,

Eliason³

2011

American Journal of Therapeutics

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Purple toe syndrome is a rarely reported adverse effect of warfarin. In all described cases, the syndrome occurred relatively quickly after initiation of warfarin with little recommendation for treatment in patients needing continued anticoagulation. We encountered a patient who developed purple toes after 1 year of warfarin therapy. The warfarin was stopped, and fondaparinux was substituted with prompt resolution of all his symptoms. This is the first case describing late onset purple toe syndrome with warfarin with successful substitution with fondaparinux.

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Current awareness: Pharmacoepidemiology and drug safety

2009

Pharmacoepidemiology and Drug

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In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of pharmacoepidemiology and drug safety. Each bibliography is divided into 23 sections: 1 Reviews; 2 General; 3 Anti‐infective Agents; 4 Cardiovascular System Agents; 5 CNS Depressive Agents; 6 Non‐steroidal Anti‐inflammatory Agents; 7 CNS Agents; 8 Anti‐neoplastic Agents; 9 Haematological Agents; 10 Neuroregulator‐Blocking Agents; 11 Dermatological Agents; 12 Immunosuppressive Agents; 13 Autonomic Agents; 14 Respiratory System Agents; 15 Neuromuscular Agents; 16 Reproductive System Agents; 17 Gastrointestinal System Agents; 18 Anti‐inflammatory Agents ‐ Steroidal; 19 Teratogens/fetal exposure; 20 Antidiabetic Agents; 21 Contrast Agents; 22 Bone Conservation Agents; 23 Others. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted.

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A case of unilateral purple toes due to warfarin

Cited by 9 publications

References 5 publications

Adverse Drug Reactions and Cutaneous Manifestations Associated With Anticoagulation

Adverse Drug Reactions and Cutaneous Manifestations Associated With Anticoagulation

Late Onset Purple Toe Syndrome With Warfarin Successfully Treated With Fondaparinux

Current awareness: Pharmacoepidemiology and drug safety

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