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Severe cutaneous and venous damage after DIC therapy

T Yuasa¹, Y Taniguchi, E Yamada

¹Department of Dermatology, Mie University School of Medicine, Japan.

The Journal of Dermatology

|July 1, 1997

Summary

A patient developed severe skin ulcers along the great saphenous vein after gabexate mesilate therapy for disseminated intravascular coagulation (DIC). Healing was poor, necessitating surgical debridement and skin grafts.

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Area of Science:

Vascular Surgery
Dermatology
Pharmacology

Background:

Disseminated intravascular coagulation (DIC) is a serious condition requiring complex treatment.
Gabexate mesilate is an anticoagulant used in managing DIC.
Vascular access for drug administration requires careful consideration of potential complications.

Observation:

A 79-year-old female patient received gabexate mesilate via injection into the right great saphenous vein.
Despite no extravasation, the patient developed purpura, pigmentation, and extensive necrotic ulcers along the vein.
The ulcers persisted for over three months, indicating poor healing.

Findings:

The study reports a rare case of severe cutaneous adverse reaction to gabexate mesilate therapy.

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The observed ulcers were extensive, affecting the thigh to the malleolus.

The condition necessitated aggressive surgical intervention, including debridement and skin grafting.

Implications:

This case highlights the potential for severe local tissue damage from intravenous gabexate mesilate, even without extravasation.
Clinicians should be vigilant for such complications in patients undergoing DIC therapy.
Further research into the mechanisms of gabexate mesilate-induced skin necrosis may inform safer administration protocols.