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Warfarin induced skin necrosis
  1. Nupur B. Patel,
  2. Gaurav Jain
  1. Anesthesia and Critical Care, AIIMS Rishikesh, Rishikesh, Uttarakhand, India
  1. Correspondence to Dr Nupur B. Patel, Rishikesh, India; nupurbpatel{at}

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Warfarin, a double sword not only helps in anticoagulation by inhibition of vitamin K dependent clotting factors but also prevents clot lysis by inhibiting protein C and protein S. The half-life of protein C and S is shorter than vitamin K dependent clotting factors hence its plasma concentration falls faster. If started alone the patient is at risk of developing warfarin induced skin necrosis, a potentially disastrous although …

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  • Contributors NBP: planning, writing and submitting the case. GJ: helped in writing the case.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.