Pharmacological analysis and remote monitoring of a patient with skin ulcers caused by anticoagulation

A woman in her 76 s has valvular heart disease, atrial fibrillation, and myelodysplastic syndrome. Warfarin bridged with low molecular weight heparin (LMWH), was treated for anticoagulation therapy in this patient. Five days later, The patient informed the anticoagulant management personnel from the APP of abnormal coagulation, thrombocytopenia, and ulcers, as well as pain in the left forearm pinhole, by Atrial fibrillation management mobile app software “Guidance on alfalfa anticoagulation”. Following the diagnosis of warfarin-induced skin ulceration, the patient received intravenous vitamin K and fresh frozen plasma (FFP) to reverse the effects of warfarin. After 3 days of effective treatment, the patient 's forearm ulceration improved and healed soon. This case highlights the importance of telemedicine in patients with anticoagulant therapy. And warfarin should be used with caution in patients with HIT, HIT antibodies detection should be requested in patients presenting with thrombocytopenia after using of heparin. We suggest that medical staff should provide the remote medical and remote drug monitoring for patients with chronic diseases and those taking high-risk drugs.