[Hemorrhagic bullous dermatosis (HBD): A rare side-effect of heparins].
Dermatose bulleuse hémorragique (DBH) : un effet indésirable rare des héparines.
Bullous haemorrhagic dermatosis
Dermatose bulleuse hémorragique
Enoxaparin
Heparins
Héparine
Héparine de bas poids moléculaire
Low molecular weight heparin
Énoxaparine
Journal
Annales de dermatologie et de venereologie
ISSN: 0151-9638
Titre abrégé: Ann Dermatol Venereol
Pays: France
ID NLM: 7702013
Informations de publication
Date de publication:
Historique:
received:
08
12
2018
revised:
04
02
2019
accepted:
21
08
2019
pubmed:
2
2
2020
medline:
28
5
2021
entrez:
2
2
2020
Statut:
ppublish
Résumé
Bullous haemorrhagic dermatosis (BHD) induced by heparin is a rare and benign side effect of which we report two cases. Case 1: an 81-year-old man presented haemorrhagic bullae on the limbs and trunk 7 days after starting enoxaparin. The laboratory haemostasis assessment was normal. A diagnosis was made of BHD induced by enoxaparin and the patient's treatment was switched to apixaban, resulting in a favourable outcome with resolution of the lesions within 15 days. Case 2: a 71-year-old woman hospitalised for pulmonary embolism was given tinzaparin. At two months of treatment, haemorrhagic bullae were observed on her forearms at distance from the injection sites. A diagnosis of BHD induced by tinzaparin was made. Treatment with tinzaparin was continued and the lesions resolved within 15 days. Heparin-induced BHD is a rare entity initially described in 2006. Ninety-five cases of heparin-induced BHD have been reported. It is characterized by multiple haemorrhagic bullae at a distance from the injection sites. Time to onset of lesions after heparin initiation ranges from 24h to 4 months. Laboratory assessment should be routinely performed to rule out any haemostasis disorders. Lesions subside within 15 days whether heparin is continued or withdrawn. Heparin-induced BHD is a rare but benign side effect of heparins. In the absence of recommendations, therapeutic management should be adapted to the individual situation.
Sections du résumé
BACKGROUND
BACKGROUND
Bullous haemorrhagic dermatosis (BHD) induced by heparin is a rare and benign side effect of which we report two cases.
PATIENTS AND METHODS
METHODS
Case 1: an 81-year-old man presented haemorrhagic bullae on the limbs and trunk 7 days after starting enoxaparin. The laboratory haemostasis assessment was normal. A diagnosis was made of BHD induced by enoxaparin and the patient's treatment was switched to apixaban, resulting in a favourable outcome with resolution of the lesions within 15 days. Case 2: a 71-year-old woman hospitalised for pulmonary embolism was given tinzaparin. At two months of treatment, haemorrhagic bullae were observed on her forearms at distance from the injection sites. A diagnosis of BHD induced by tinzaparin was made. Treatment with tinzaparin was continued and the lesions resolved within 15 days.
DISCUSSION
CONCLUSIONS
Heparin-induced BHD is a rare entity initially described in 2006. Ninety-five cases of heparin-induced BHD have been reported. It is characterized by multiple haemorrhagic bullae at a distance from the injection sites. Time to onset of lesions after heparin initiation ranges from 24h to 4 months. Laboratory assessment should be routinely performed to rule out any haemostasis disorders. Lesions subside within 15 days whether heparin is continued or withdrawn.
CONCLUSION
CONCLUSIONS
Heparin-induced BHD is a rare but benign side effect of heparins. In the absence of recommendations, therapeutic management should be adapted to the individual situation.
Identifiants
pubmed: 32005507
pii: S0151-9638(19)31074-9
doi: 10.1016/j.annder.2019.08.021
pii:
doi:
Substances chimiques
Anticoagulants
0
Enoxaparin
0
Tinzaparin
7UQ7X4Y489
Types de publication
Case Reports
Journal Article
Langues
fre
Sous-ensembles de citation
IM
Pagination
446-450Informations de copyright
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