Bullous hemorrhagic dermatosis: a case report.

Area of Science:

• Dermatology
• Pharmacology

Background:

• Enoxaparin is a widely used low-molecular-weight heparin for deep vein thrombosis prophylaxis.
• Adverse dermatological reactions to enoxaparin are uncommon but can be severe.

Purpose of the Study:

• To report a rare case of hemorrhagic bullous dermatosis distant from enoxaparin injection sites.
• To contribute to the limited global literature on this specific adverse drug reaction.

Main Methods:

• Case report of an 88-year-old female patient admitted for intertrochanteric fracture.
• Patient received enoxaparin 60mg subcutaneously every 12 hours for deep vein thrombosis prophylaxis.
• Clinical presentation, diagnosis, and treatment of the dermatological reaction were documented.

Main Results:

• The patient developed large hemorrhagic bullae on the left leg and other distant sites, 5 days after initiating enoxaparin.
• Diagnosis of bullous hemorrhagic dermatoses secondary to enoxaparin was established.
• Discontinuation of enoxaparin and initiation of oral heparin led to lesion regression.

Conclusions:

• Enoxaparin can cause distant hemorrhagic bullous dermatoses, a rare but significant adverse effect.
• This case represents the first reported instance from India, adding to the global understanding of enoxaparin-induced skin reactions.