A rare, potentially lethal complication of anticoagulant therapy involving coumarin and its cogeners has been termed coumarin skin necrosis. The random and paradoxical aspects of this poorly understood entity involve the sites affected, the relationship of lesions to schedules of drug administration, and the sequence and extent of lesions. Almost unknown is an effective, potentially life-saving treatment requiring the use of heparin. Because of a sequence of symmetric lesions and the use of heparin therapy, the pathogenesis of the lesion and the role of heparin have been delineated.
© 1971 The American College of Obstetricians and Gynecologists