Skin necrosis of genitalia and warfarin therapy

Unusual complications of warfarin therapy: skin necrosis and priapism

Skin necrosis and priapism are unusual complications of warfarin therapy. We report a teenager with warfarin-associated skin necrosis and priapism who was subsequently found to be a compound heterozygote for protein C deficiency and a heterozygote for the factor V Leiden mutation.

Coumarin necrosis of the penis

Coumarin-induced necrosis of the skin and subcutaneous tissue is an uncommon but well recognized complication of anticoagulant therapy. Although any area of skin may be involved necrosis of the penis is rare. We report a case of penile necrosis associated with coumarin therapy and review the literature.

Genital necrosis secondary to warfarin therapy

Several adverse dermatologic effects have been reported with the use of warfarin. Among these is the rare complication of drug-induced necrosis. Approximately 150 cases had been reported by 1976, and a review of the literature since 1943 revealed only 4 reported cases of penile necrosis. We present the fifth case of genital necrosis reported with coumarin anticoagulants and the third such case associated with warfarin.

Penile gangrene: a complication of secondary hyperparathyroidism from chronic renal failure

We present the third case and first reported survivor of penile gangrene due to secondary hyperparathyroidism from chronic renal failure. The patient was treated with distal penectomy and subtotal parathyroidectomy. This case stimulated us to review the metabolic and vascular changes associated with secondary hyperparathyroidism in chronic renal failure. Secondary hyperparathyroidism may cause diffuse vasculitis and vascular calcification, which can lead to widespread ischemic necrosis and gangrene. Early medical therapy, including oral phosphate binders, is crucial to maintain the serum calcium-phosphate product below precipitation level. Subtotal parathyroidectomy is indicated for patients in whom progressive arterial and soft tissue calcification develops despite medical therapy.

Warfarin necrosis of the skin and subcutaneous tissue of the male external genitalia

Gangrene of the male external genitalia is an uncommon urologic problem with a limited differential diagnosis. To the etiologic spectrum we add warfarin-induced penile gangrene. Pathophysiology, diagnosis and treatment are discussed.

Dermal gangrene. A rare complication of warfarin therapy

Two cases of dermal gangrene following warfarin therapy are described and a review of the literature is given.