Warfarin-induced skin necrosis of the eyelids.

Skin necrosis is a rare complication of warfarin therapy that occurs between the third and 10th days of treatment. The pathogenesis of warfarin-induced skin necrosis is attributable to the emergence of a transient hypercoagulable state. The condition most commonly involves skin areas with abundant subcutaneous adipose tissue such as the breasts, buttocks, abdomen, thighs, and the extremities. We report the case of an 83-year-old woman who developed bilateral medial canthal skin necrosis following initiation of warfarin therapy.