Dermatology - Disseminated Intravascular Coagulation

Dermatology - Disseminated Intravascular Coagulation 
Disseminated intravascular coagulation is a prevalent condition characterized by abnormal blood clotting that occurs throughout the blood arteries. This disorder is commonly linked to many clinical situations such as bacterial sepsis, obstetric difficulties, disseminated malignancy, or severe trauma.


The clinical manifestations of DIC can vary from mild and asymptomatic to severe and potentially fatal. The symptoms manifest gradually over a period of hours to days, characterized by fever, chills, tachycardia, and potentially indicators of shock. Hemorrhage can also occur from various cutaneous sites, such as surgical wounds, venipuncture, or catheter sites. Bleeding from the gums may also happen.

Infarction (purpura fulminans) or extensive ecchymoses arise with sharp, irregular (“geographic”) boundaries with deep purple to blue color and erythematous halo and may evolve to hemorrhagic bullae or blue to black gangrene. Frequently, there are several symmetrical lesions located on the outermost parts of the limbs, regions subjected to pressure, lips, ears, nose, or torso. Peripheral acrocyanosis can progress to gangrene in the hands, feet, and tip of the nose, leading to autoamputation.

The diagnosis is made based on clinical observations and verified through coagulation testing. Possible causes of significant cutaneous infarctions that need to be considered are necrosis resulting from the start of warfarin treatment, heparin necrosis, calciphylaxis, and atheroembolization.

Administer systemic antimicrobials to treat infections. To manage bleeding or thrombosis, administer heparin, pentoxifylline, and protein C concentrate, while also providing supportive care.