Skin necrosis at the injection site induced by low-molecular-weight heparin: case report and review

Dermatology. 1998;196(2):264-5. doi: 10.1159/000017889.


Heparin-induced skin necrosis at the injection site is a rare adverse effect, more commonly associated with standard heparins than with low-molecular-weight heparins (LMWH) and its mechanism remains unclear. We report a case of LMWH-induced skin necrosis in a female during prophylactic treatment with LMWH after a surgical procedure. Determination of heparin-platelet-factor-4(PF4)-induced antibodies was positive. This case describes the occurrence of LMWH-induced skin necrosis and antibodies to heparin-PF4 complex, suggesting that this effect is more frequent than previously suspected.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anticoagulants / administration & dosage
  • Anticoagulants / adverse effects*
  • Anticoagulants / therapeutic use
  • Female
  • Heparin, Low-Molecular-Weight / administration & dosage
  • Heparin, Low-Molecular-Weight / adverse effects*
  • Heparin, Low-Molecular-Weight / therapeutic use
  • Humans
  • Injections, Subcutaneous
  • Necrosis
  • Skin / pathology*
  • Skin Diseases / chemically induced*


  • Anticoagulants
  • Heparin, Low-Molecular-Weight