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Updated: Jun 17, 2026

A Standardized Procedure of Dressing Management for Toxic Epidermal Necrolysis

A Standardized Procedure of Dressing Management for Toxic Epidermal Necrolysis

Published on: March 14, 2025

Warfarin-induced skin necrosis.

Seema Inayatullah¹, Gautam Phadke, Leonid Vilenski

¹MeritCare Health System, Department of Internal Medicine, University of North Dakota School of Medicine, Fargo, ND, USA.

Southern Medical Journal

|December 10, 2009

Summary

Guidelines are lacking for managing warfarin-induced skin necrosis, including heparin use and warfarin continuation. This case report highlights challenges in vitamin K antagonist therapy.

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Last Updated: Jun 17, 2026

A Standardized Procedure of Dressing Management for Toxic Epidermal Necrolysis

A Standardized Procedure of Dressing Management for Toxic Epidermal Necrolysis

Published on: March 14, 2025

Area of Science:

Cardiology
Pharmacology
Dermatology

Background:

Warfarin therapy is crucial for preventing thromboembolic events but carries risks, including skin necrosis.
Warfarin-induced skin necrosis (WISN) is a rare but severe complication requiring careful management.
Current clinical guidelines for managing WISN are limited, particularly concerning anticoagulation strategies.

Observation:

This case report details a patient experiencing warfarin-induced skin necrosis.
The report focuses on the complexities of intravenous heparin administration and subsequent warfarin use.
Challenges in patient selection and treatment duration for heparin were encountered.

Findings:

A significant gap exists in established protocols for heparin selection and duration in WISN cases.
Managing vitamin K antagonist (VKA) therapy presents considerable clinical challenges.
The report underscores the need for clearer guidelines in preventing and treating WISN.

Implications:

This case highlights the critical need for evidence-based guidelines in managing warfarin-induced skin necrosis.
Improved understanding and protocols can enhance patient outcomes and reduce complications associated with VKA therapy.
Further research is warranted to address the therapeutic uncertainties in WISN management.