Extensive bullae formation in acute iliofemoral venous thrombosis

A 58-year-old man presented with an acutely painful swollen left leg which was cyanotic and crowded with cutaneous bullae. After confirmation with color duplex ultrasound, intravenous streptokinase therapy was commenced with a bolus of 250,000 IU followed by maintenance infusion of 100,000 IU hourly for 72 hours. Treatment was changed to heparin for 14 days and then oral warfarin for another 6 months. Effacement of bullae accompanied subsidence of swelling of the leg. This case highlights the potential contribution of fluid retention in acute deep venous thrombosis to extensive bullae formation. This has not been previously reported in the literature.