Possible apixaban-induced leukocytoclastic vasculitis.

Area of Science:

• Pharmacology
• Hematology
• Dermatology

Background:

• Deep vein thrombosis (DVT) is a serious condition requiring anticoagulant therapy.
• Direct oral anticoagulants (DOACs) like apixaban are commonly used for DVT treatment.
• Adverse drug reactions can complicate anticoagulant therapy.

Observation:

• A 74-year-old female patient with DVT developed a rash on apixaban therapy.
• The rash was diagnosed as leukocytoclastic vasculitis (LCV) by dermatology.
• LCV symptoms progressively worsened during apixaban treatment.

Findings:

• Discontinuation of apixaban and initiation of rivaroxaban led to LCV improvement.
• The patient completed DVT treatment with rivaroxaban without LCV recurrence.
• This case highlights a potential adverse effect of apixaban.

Implications:

• Physicians should consider LCV as a potential adverse effect of apixaban.
• Transitioning to an alternative anticoagulant, such as rivaroxaban, may be effective for managing apixaban-induced LCV.
• This case contributes to understanding the safety profile of DOACs.