Derms can make early dx of acute cutaneous necrosis

Dermatologists are uniquely qualified to make early diagnosis of acute cutaneous necrosis, which allows early therapeutic intervention and improves overall outcome for these patients, says John C. Hall, M.D.

Acute cutaneous necrosis has become more common in both outpatient and inpatient settings due to such factors as an increase in cardiac procedures, increased rates of renal transplants and renal dialysis, increased use of anticoagulants, and a greater incidence of patients with immune systems compromised by HIV, chemotherapy or organ transplants, says Dr. Hall, who will discuss this topic today.

The most important tools for early diagnosis are a review of drug history, such as use of coumadin and heparin; knowledge of underlying conditions such as sepsis, HIV infection, immune suppression, diabetes, renal disease and arteriosclerotic vascular disease; performance of a skin biopsy with culture and appropriate staining for organisms; and assessment of the overall condition of the patient as well as location on the skin and location of the patient when symptoms are first noticed, Dr. Hall says.