Warfarin-induced major unilateral breast necrosis in a patient with antiphospholipid syndrome: A case report

INTRODUCTION: Warfarin-induced necrosis is a rare complication associated with the use of warfarin in addition to antiphospholipid syndrome. CASE PRESENTATION: A 50-year-old female patient with a known case of antiphospholipid syndrome started warfarin treatment for ischaemic changes in her toes and subsequently experienced warfarin-induced necrosis in her left breast. Then, warfarin treatment was suspended, and she was started on enoxaparin. Debridement was performed, and a skin graft was applied without complications. DISCUSSION: Skin necrosis has many differential diagnoses, and physicians must take a proper history and perform a physical examination with proper investigations involving a multidisciplinary team, including plastic surgery, haematology, internal medicine, and wound care specialists. Plastic surgery offers many options for reconstruction depending on the patient’s medical condition, the size of the wound and the location following the reconstructive ladder. CONCLUSION: This case report presents a rare complication of warfarin in the context of antiphospholipid syndrome and describes the management of unilateral breast necrosis. Physicians should be highly suspicious of this condition in patients with skin necrosis who were administered warfarin or have antiphospholipid syndrome.