Heparin induced skin necrosis

Question 1

How does Heparin induced skin necrosis present?

Answer 1

• decreased platelets
• thrombosis (which seems counterintuitive with decrease in platelets)
• cutaneous necrosis

Question 2

What is the mechanism of Heparin induced thrombocytopenia with thrombosis syndrome?

Answer 2

• autoantibodies against heparin/platelet factor 4 complexes→ Coumadin induced skin-necrosis→ consumption of platelets, and aggregates of platelets bound by antibodies causing the clotting

Question 3

Treatment of Heparin induced thrombocytopenia with thrombosis:

Answer 3

1. stop heparin
2. start Factor 10a inhibitor