Pharmacy Medical News about Skin Abnormalities Heparin

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Incidence and causes of heparin-induced skin lesions
Canadian Medical Association Journal, 10/19/09

Schindewolf M et al. – Heparin–induced skin lesions are relatively common, have identifiable risk factors and are commonly caused by a delayed–type hypersensitivity reaction (type IV allergic response).

Methods

The authors prospectively examined consecutive patients who received subcutaneous heparin (most often enoxaparin or nadroparin) for the presence of heparin–induced skin lesions.
If such lesions were identified, the authors performed a skin biopsy, platelet count measurements, and antiplatelet–factor 4 antibody and allergy testing.

Results

The authors enrolled 320 patients.
In total, 24 patients (7.5%, 95% confidence interval [CI] 4.7%–10.6%) had heparin–induced skin lesions.
Delayed–type hypersensitivity reactions were identified as the cause in all 24 patients.
One patient with histopathologic evidence of delayed–type hypersensitivity tested positive for antiplatelet–factor 4 antibodies.
The authors identified the following risk factors for heparin–induced skin lesions: a body mass index greater than 25, duration of heparin therapy longer than 9 days and female sex.

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