[Cholesterol embolization following anticoagulant treatment]

A 65-year-old female patient with pulmonary embolism developed widespread, extremely painful hemorrhagic necroses of the skin and subcutaneous tissue of the lower extremities 5 weeks after initiation of anticoagulation therapy. Due to the clinical and histopathologic findings and the course of the disease, a diagnosis of cholesterol embolization was made. The characteristic features of this clinical entity and differential diagnostic considerations are discussed.