Understanding Lab Tests for Warfarin-induced skin necrosis
Written by Private MD Labs Medical Writing Team • Last Updated: September 8, 2025
Warfarin-induced skin necrosis is a rare but serious complication that can occur when starting warfarin therapy. While the condition is diagnosed through clinical examination of skin changes, blood tests play a crucial role in identifying patients at higher risk before starting treatment and understanding the underlying mechanisms.
Top Recommended Test
Protein C Activity
This test measures the functional activity of Protein C, a natural anticoagulant protein. Patients with pre-existing Protein C deficiency are at increased risk of warfarin-induced skin necrosis because warfarin initially decreases Protein C activity before producing its therapeutic anticoagulant effect, potentially creating a temporary hypercoagulable state.
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Why Blood Testing is Important
While there is no single blood test to diagnose warfarin-induced skin necrosis itself, testing for protein deficiencies is fundamental for assessing risk factors before initiating warfarin therapy. Patients with certain protein deficiencies are at significantly higher risk of developing this complication because warfarin initially decreases these protective proteins before achieving its intended anticoagulant effect.
Other Relevant Tests
Protein S Antigen, Free
This test measures the level of free Protein S antigen, another important natural anticoagulant. Individuals with protein S deficiency face increased risk of developing warfarin-induced skin necrosis because warfarin initially decreases Protein S levels, which can lead to a hypercoagulable state and subsequent skin necrosis during the early phases of treatment.
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Understanding the Risk
Testing for Protein C and Protein S deficiencies before starting warfarin can help healthcare providers identify high-risk patients and take appropriate preventive measures, such as bridging with heparin or using alternative anticoagulants. Early identification of these deficiencies is essential for preventing this potentially devastating complication.
Important Considerations
The information here is for educational purposes only and is not a substitute for professional medical advice. Always consult with a healthcare provider for diagnosis and treatment.
