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Purple Toe Syndrome

| Anticoagulants, Heparin, Uncategorized, Warfarin (Coumadin) | Comments Off on Purple Toe Syndrome

Warfarin can, in rare instances, cause violaceous painful discoloration of the toes and the sides of the feet, referred to as the “purple toe syndrome” 1 – see photograph below. Occasionally, the hands can also be involved and a net-like skin rash on abdomen and legs (= livedo reticularis) can occur. This typically happens within the first few weeks of starting warfarin. It rarely occurs later – one case publication reported occurrence after 1 year on warfarin 2.

Purple toe syndrome in a patient 5 weeks after having started warfarin


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