Aftermath of Apixaban: Atypical Anticoagulation Aftereffect

Aftermath of Apixaban: Atypical Anticoagulation Aftereffect

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An elderly man with prostate cancer and a deep vein thrombosis (DVT) of the lower extremity diagnosed 12 days ago on apixaban presented with a new-onset palpable rash on both of his legs.Extensive laboratory workup was largely unremarkable, except for multiple skin punch arcade smokey the bear belt biopsies revealing deposition of immunoglobulin A (IgA) in the superficial blood vessels with infiltration of leukocytes, concerning for a small vessel vasculitis.Given the temporal association along with the negative workup, discount greenery the rash was attributed to apixaban, and the anticoagulation regimen was switched to dabigatran.At a 2-week follow-up visit, the patient was asymptomatic and tolerating dabigatran without any adverse events.