case_images: PMC11758867_01
case_images: PMC11758867_02
case_images: Occlusive lesions in a 43-year-old female at baseline, immediately before starting the combined hyaluronidase and topical heparin treatment (A); favorable evolution after 3 and 7 days (B and C, respectively), and highly satisfactory aesthetic outcomes after 1 more week of combined therapy (D).
case_images: ojae126f3.jpg
case_images: PMC11758867_02_ojae126f3.jpg
case_images: ojae126-F3
case_images:  Figure 3 documents the baseline presentation of the occlusive skin lesions 2 h after the same-session topical low-molecular-weight heparin application (Figure 3A), the evolution over the first week (Figure 3B, C), and the almost complete skin repair after 15 days (Figure 3D).
case_images: (A) Baseline presentation of occlusive lesions in a 34-year-old female a few minutes after the hyaluronidase injection; (B) a worsening situation after 3 days and slow, unsatisfactory improvement after 7 days (C), vs highly satisfactory aesthetic outcomes on the 28th day (D) after starting topical enoxaparin (early second week) and applying it 3 times daily for 3 additional weeks.
case_images: ojae126f4.jpg
case_images: PMC11758867_02_ojae126f4.jpg
case_images: ojae126-F4
case_images:  Figure 4 illustrates the severe baseline presentation of the occlusive skin lesions shortly after the hyaluronidase injection (Figure 4A) and the unsatisfactory clinical progression over the first week, with impressive worsening observed on the third day (Figure 4B, C). Figure 4D documents the final, nearly complete skin repair after 3 more weeks of 3-times-daily topical application of low-molecular-weight heparin and a total of 28 days of follow-up.