Leukocytoclastic vasculitis: another coumarin-induced hemorrhagic reaction

A 67-year-old male developed a hemorrhagic eruption 4 weeks after initiation of coumarin therapy. Examination revealed a well-demarcated, purple patch with a central hemorrhagic bulla on the anterior aspect of the leg, surrounded by small petechiae. Histological examination of the purple plaque revealed leukocytoclastic vasculitis. It is suggested that leukocytoclastic vasculitis be considered in the differential diagnosis of coumarin-induced hemorrhagic reactions.