PT - JOURNAL ARTICLE AU - Weh Kiat Gan TI - Delayed-onset heparin-induced skin necrosis: a rare complication of perioperative heparin therapy AID - 10.1136/bcr-2017-221388 DP - 2017 Nov 03 TA - BMJ Case Reports PG - bcr-2017-221388 VI - 2017 4099 - http://casereports.bmj.com/content/2017/bcr-2017-221388.short 4100 - http://casereports.bmj.com/content/2017/bcr-2017-221388.full AB - An uncommon case of delayed-onset dalteparin-induced skin necrosis in an 83-year-old Caucasian female patient associated with heparin-induced thrombocytopaenia (HIT) presenting on day 30 following dalteparin therapy is reported. Investigations revealed mild thrombocytopaenia with normal protein C, protein S, coagulation screen and positive test for heparin–platelet factor-4 antibody. Clinical diagnosis of heparin-induced skin necrosis with HIT was made. Dalteparin injection was discontinued promptly and substituted with fondaparinux therapy. The patient achieved good recovery following cessation of dalteparin therapy and was subsequently discharged.