Widespread cutaneous necrosis as the initial manifestation of the antiphospholipid antibody syndrome

We describe a patient with the acute onset of widespread cutaneous necrosis as the initial manifestation of the antiphospholipid antibody syndrome (APS). The patient was effectively treated with corticosteroids and anticoagulants, however extensive skin grafting was eventually required. We review 6 other reported cases and discuss the various underlying etiologies of vascular thrombosis resulting in cutaneous necrosis. Early recognition and treatment of the APS may limit the extent of thrombotic complications that can result in tissue necrosis.