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A 59-year-old African-American woman with a history of renal failure and deep-vein thrombosis (DVT) was admitted to the hospital for altered mental status and confusion. At the time of admission, she was taking warfarin therapy for her DVT. During a magnetic resonance imaging (MRI) of her head, she had a generalized tonic-clonic seizure, which was not seen on the MRI.
The patient was started on phenytoin (Dilantin) for seizure control. The following morning, her hand was edematous, with dark discoloration of the dorsal and palmar aspects (Figures 1, 2). She had no tenderness at the site, and there was no breakdown of the skin with gentle stroking. Her neurologic examination was normal, as was her range of motion.
What's Your Diagnosis?
1- Warfarin-induced skin necrosis
2- Raynaud's disease
3- Staphylococcal scalded skin syndrome
4- Purple glove syndrome
The patient was started on phenytoin (Dilantin) for seizure control. The following morning, her hand was edematous, with dark discoloration of the dorsal and palmar aspects (Figures 1, 2). She had no tenderness at the site, and there was no breakdown of the skin with gentle stroking. Her neurologic examination was normal, as was her range of motion.
What's Your Diagnosis?
1- Warfarin-induced skin necrosis
2- Raynaud's disease
3- Staphylococcal scalded skin syndrome
4- Purple glove syndrome
