Author: A/Prof Patrick Emanuel, Dermatopathologist, Auckland, New Zealand, 2013.
Warfarin necrosis is a paradoxical blood clotting occurring in patients on warfarin therapy. It occurs in approximately one in every 10,000 patients prescribed warfarin.
Histology of warfarin necrosis
In warfarin necrosis, sections show variable degrees of epidermal and dermal necrosis (figure 1). There are extensive intravascular thrombi within capillaries and venules (figures 2, 3). There remaining patent vessels are dilated.