Adverse reactions of subcutaneous
low molecular weight heparin or
unfractionated heparin could be
complications by
bleeding,
heparin-induced
thrombocytopenia, drug-induced liver injury,
osteoporosis, and cutaneous reactions.
Heparin-induced
skin lesions vary from
allergic reactions like
erythema,
urticaria,
eczema to intradermal microvascular
thrombosis associated with
heparin-induced
thrombocytopenia. There is a rare cutaneous complication, called bullous hemorrhagic
dermatosis. We experienced this rare case of the cutaneous complication caused by
enoxaparin. Several tense bullous hemorrhagic lesions occurred after 3 days of
enoxaparin in a known
bullous pemphigoid patient who had
aortic valve replacement
surgery with a mechanical
prosthesis. The bullous hemorrhagic lesions were regressed after the discontinuation of
enoxaparin but recurred after re-
administration. The lesions were controlled by the
administration of systemic
corticosteroid and alternative
anticoagulant. To date, less than 20 cases have been reported worldwide. This is the first case of bullous hemorrhagic
dermatosis induced by
enoxaparin, a
low-molecular-weight heparin in
Korea. This is also the first case of bullous hemorrhagic
dermatosis in a known
bullous pemphigoid patient.