Haemorrhagic bullae induced by oral anticoagulants

A 77-year-old patient developed haemorrhagic bullae on her fingers 30 months after initiation of anti-coagulation treatment with warfarin sodium for chronic atrial fibrillation and mitral insufficiency. The bullae resolved 10 days after discontinuation of the medication. Two weeks after initiation of sintrom, (3-alpha-(4-nitrophenyl)-beta-acetylethyl-4-hydroxy coumarin), the lesions recurred and resolved again upon cessation of the drug. This adverse skin reaction has not been hitherto reported.