Necrosis cutánea extensa por terlipresina

Terlipressin-related Ischaemic Necrosis of the Skin: A Rare Complication

“…Terlipressin is a synthetic vasopressin analogue used in the treatment of upper gastro-intestinal bleeding from oesophageal varices. It has a half-life of approximately 6 hours [1] . This drug also has high affinity for type V1 receptors located in the smooth muscles of blood vessels mostly in the splenic, renal, myometrial, bladder, adipocyte and cutaneous circulations [1–3] .…”

“…It has a half-life of approximately 6 hours [1] . This drug also has high affinity for type V1 receptors located in the smooth muscles of blood vessels mostly in the splenic, renal, myometrial, bladder, adipocyte and cutaneous circulations [1–3] . Its vasoconstrictor effect is similar to that of vasopressin but requires a lower dosage with fewer side effects.…”

“…Our patient had greater skin involvement affecting the upper and lower limbs, scrotum and abdomen. This atypical localization of necrotic areas could be explained by the existence of areas of thicker skin, extra fatty tissue [1] and the hypothesis of a heterogeneous distribution of V1 receptors.…”

“…The risk factors for ischaemic skin complications described in the literature include ischaemic disease, obesity, ascites, venous insufficiency, spontaneous bacterial peritonitis, hypotension, vasopressor drugs administered concomitantly, and continuous infusion of terlipressin [1,2] . Our patient presented with venous insufficiency and episodes of hypotension secondary to gastro-intestinal haemorrhage, which could cause tissue hypoxia.…”