Photo Credit: James Mutter
The following is a summary of “Clinical Features, Diagnosis, Treatment, and Prognosis of Heparin-Induced Bullous Hemorrhagic Dermatosis,” published in the March 2024 issue of Dermatology by Li, et al.
Heparin-induced bullous hemorrhagic dermatosis (HBHD) is a rare cutaneous adverse reaction to heparin characterized by unclear clinical features. Understanding HBHD’s clinical presentation is crucial for safe heparin use. For a study, researchers conducted a retrospective analysis of HBHD-related case reports by searching Chinese and English databases until December 31, 2022.
About 72 patients were predominantly male (70.8%), with a median age of 71.5 years. Low-molecular-weight heparin was implicated in 86.1% of cases, while unfractionated heparin was used in 13.9%. HBHD typically manifested after a median of 7 days, often appearing distant from injection sites, with extremities being the most affected (79.2%). Blisters were commonly intraepidermal (47.2%), subcorneal (13.9%), or subepidermal (12.5%). A majority (51.4%) showed no significant dermal inflammatory infiltration, while lymphocytic infiltration occurred in 27.8% of cases. Most patients (93.1%) experienced lesion resolution, either upon heparin discontinuation or while continuing treatment, within a median of 14 days.
HBHD is a rare, self-limiting condition that typically manifests distally from injection sites. Clinicians should maintain vigilance for HBHD during heparin administration, with treatment decisions based on individual patient circumstances.
Reference: hindawi.com/journals/dth/2024/1372188/
