Enoxaparin sodium
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Bullous haemorrhagic dermatosis: case report A 77-year-old man developed bullous haemorrhagic dermatosis during anticoagulant treatment with enoxaparin sodium. The man had a history of diabetes, chronic obstructive pulmonary disease, hypertension, revascularised acute myocardial infarction with stent placement in the anterior descending and right circumflex arteries and atrial flutter. He had been receiving antiaggregation therapy with aspirin [acetylsalicylic acid] and anticoagulant therapy with acenocoumarol. Subsequently, he was diagnosed with advanced small cell lung cancer with dysphagia due to extrinsic compression by a mediastinal tumour mass, and was started on unspecified chemotherapy. His acenocoumarol therapy was switched to enoxaparin sodium [enoxaparin; dosage and route not stated] to decrease the risk of pharmacological interactions with acenocoumarol. However, he presented with bullous skin lesions of bleeding appearance, well-delimited, dark with minimal erythema surrounding them after one month of enoxaparin sodium initiation. Biopsy of the lesion showed presence of an intra-epidermal blister with blood content inside without thrombotic events or polymorphonuclear cells. A diagnosis of bullous haemorrhagic dermatosis secondary to enoxaparin sodium was made. The man’s treatment with enoxaparin sodium was stopped, and he was treated with fondaparinux sodium [fondaparinux]. Within 4 days, his skin lesions completely resolved. Gutierrez Lopez de Ocariz X, et al. Bullous hemorrhagic dermatosis induced by low molecular weight heparins. Medicina Clinica 155: 137, No. 3, 14 Aug 2020. Available 803506665 from: URL: http://doi.org/10.1016/j.medcli.2019.05.015 [Spanish; summarised from a translation]
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Reactions 10 Oct 2020 No. 1825
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