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Low‐molecular‐weight heparin‐induced skin necrosis: a potential association with pre‐existent hypercoagulable states

A 76‐year‐old patient was admitted to our hospital with dyspnea. His past medical history disclosed a 17‐year duration of polycythemia vera with thrombocytosis; arterial hypertension; diabetes mellitus; hyperuricemia; auricular fibrillation; and chronic bronchitis. He had been treated with hydroxyurea, digoxin, allopurinol, and enalapril. Although pulmonary embolism was not demonstrated, at admission, as a result of the presence of thrombocytosis and arrhythmia, prophylactic treatment with subcutaneous enoxaparin, 60 mg twice daily, was prescribed.