Nose Necrosis in Female Shocked Patient: Conservative Treatment with Heparin

Acute skin failure is an event in which skin and underlying tissue die due to hypoperfusion concurrent with a critical illness [1]. Usually skin hypoperfusion is a late symptom in a shock setting and it is present in patients with an advanced multiorgan failure (MOF) dysfunction. Acute skin damage is mainly present in feet and hands as consequence of distal hypoperfusion due to hypotension or microthrombotic events [2]. Face is less commonly affected. In some cases of purpura fulminas there is anyway an important face skin involvement. Purpura fulminans is usually associated with meningococcal sepsis, varicella, and pneumococcal infections and\or coagulation disorders [3-4]. We present the clinical case of a young woman occurring at our hospital with nose skin necrosis as first sing of shock setting.