Heparin-Induced Thrombocytopenia – Physical Exam

Physical exam in heparin-induced thrombocytopenia (HIT). Despite the presence of thrombocytopenia, patients rarely bleed. Rather, one-third to a half of all patients with HIT paradoxically develop thromboembolic complications, which account for most physical findings, including those related to the limbs, lungs, and adrenal glands. Skin lesions occur in 10–20% of patients with HIT (not shown). These lesions, which are due to intradermal microvascular thromboses, are similar to a delayed-type hypersensitivity reaction: they begin as erythematous lesions and can then become cutaneous necroses that generally have a central black eschar surrounded by an indurated erythema (see Lancet. 2012;380:1867-79).