RT Journal Article SR Electronic T1 Rare presentation of enoxaparin-induced skin necrosis in a postoperative patient JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e249685 DO 10.1136/bcr-2022-249685 VO 15 IS 4 A1 Emma McNell Byrne A1 Ahmed Khattab A1 Feifan Chen A1 Rama Bhagavatula YR 2022 UL http://casereports.bmj.com/content/15/4/e249685.abstract AB Enoxaparin-induced skin necrosis is a rare complication of low-molecular weight heparin (LMWH) therapy. We describe a woman in her 50s who developed deep vein thrombosis (DVT), thrombocytopenia and necrotic skin lesions after initiation of enoxaparin for DVT prophylaxis. Despite high clinical suspicion of heparin-induced thrombocytopenia syndrome and a positive heparin–platelet factor 4 antibody, heparin serotonin assay was negative. This case emphasises the importance for clinical vigilance regarding complications to LMWH therapy.