Vasopressin-induced bullous disease and cutaneous necrosis

Intravenous vasopressin is a commonly used modality for control of bleeding esophageal varices. The development of ischemic cutaneous complications is a recently described entity. In previous reports, cutaneous necrosis has occurred at sites of extravasation, at or proximal to intravenous catheter sites, or at isolated pressure points. We review the literature on vasopressin-induced cutaneous reactions and report a case of cutaneous necrosis and bulla formation in which multiple bullae formed during vasopressin therapy at sites distant from direct intravenous flow.