{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T00:15:13Z","timestamp":1792800913195,"version":"4.5.0"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Direct oral anticoagulants (DOACs), such as rivaroxaban and dabigatran, are widely used for thromboembolic conditions. While bleeding is the most well-recognized adverse effect, rare cutaneous hypersensitivity reactions, such as urticaria and angioedema, are increasingly reported. We describe a case series of nine patients who developed cutaneous hypersensitivity reactions to DOACs. All patients developed symptoms within 1-10 days of DOAC initiation. Rivaroxaban was associated with angioedema and urticaria, whereas dabigatran was limited to urticaria. All reactions resolved after drug discontinuation and symptomatic treatment. Dermatologic adverse effects of DOACs, although uncommon, warrant heightened clinical suspicion. A limitation of this study is the small sample size and absence of rechallenge confirmation of hypersensitivity. Management should be individualized. Increased awareness among dermatologists and physicians is crucial for timely management and pharmacovigilance.<\/jats:p>","DOI":"10.4103\/idoj.idoj_1280_25","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T06:01:55Z","timestamp":1787119315000},"page":"693-695","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Unmasking the Hidden Risk: Urticaria and Angioedema with Direct Oral Anticoagulants"],"prefix":"10.4103","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5476-6130","authenticated-orcid":false,"given":"Snehal","family":"Lunge","sequence":"first","affiliation":[{"name":"Department of Dermatology, Venereology and Leprosy, Bharati Vidyapeeth Medical College, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4760-5012","authenticated-orcid":false,"given":"Anshu","family":"Baghel","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprosy, Bharati Vidyapeeth Medical College, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4484-0277","authenticated-orcid":false,"given":"Vaibhav B.","family":"Patil","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bharati Vidyapeeth Medical College, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0064-731X","authenticated-orcid":false,"given":"Vidyadhar R.","family":"Sardesai","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprosy, Bharati Vidyapeeth Medical College, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"key":"R1-20260902","doi-asserted-by":"crossref","first-page":"1174","DOI":"10.1111\/imj.70103","article-title":"2025 Guidelines for direct oral anticoagulants: a practical guidance on the prescription, laboratory testing, peri-operative and bleeding management","volume":"55","author":"Tran","year":"2025","journal-title":"Intern Med J"},{"key":"R2-20260902","doi-asserted-by":"crossref","first-page":"359","DOI":"10.14740\/jmc3399","article-title":"Rivaroxaban-induced urticaria and angioedema with possible cross-reaction to dabigatran: A case report","volume":"10","author":"Patil","year":"2019","journal-title":"J Med Cases"},{"key":"R3-20260902","first-page":"3134","article-title":"Dabigatran-induced vasculitis rash on the palms: Case report and review","volume":"11","author":"Lunge","year":"2022","journal-title":"J Family Med Prim Care"},{"key":"R4-20260902","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1038\/clpt.1981.154","article-title":"A method for estimating the probability of adverse drug reactions","volume":"30","author":"Naranjo","year":"1981","journal-title":"Clin Pharmacol Ther"},{"key":"R5-20260902","doi-asserted-by":"crossref","first-page":"333","DOI":"10.11604\/pamj.2021.38.333.28401","article-title":"Anaphylaxis following rivaroxaban ingestion: report of an extremely rare case","volume":"38","author":"Khan","year":"2021","journal-title":"Pan Afr Med J"},{"key":"R6-20260902","doi-asserted-by":"crossref","first-page":"173","DOI":"10.4103\/0971-9784.129888","article-title":"Angioedema due to the new oral anticoagulant rivaroxaban","volume":"17","author":"Altin","year":"2014","journal-title":"Ann Card Anaesth"},{"key":"R7-20260902","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.4172\/2165-7920.10001059","article-title":"Angioedema two months after administration of rivaroxaban","volume":"7","author":"Banaga","year":"2017","journal-title":"J Clin Case Rep"},{"key":"R8-20260902","doi-asserted-by":"crossref","first-page":"e23","DOI":"10.1002\/phar.1203","article-title":"Rash associated with dabigatran etexilate","volume":"33","author":"To","year":"2013","journal-title":"Pharmacotherapy"},{"key":"R9-20260902","doi-asserted-by":"crossref","first-page":"1489","DOI":"10.2146\/ajhp110088","article-title":"Dabigatran-induced rash","volume":"68","author":"Eid","year":"2011","journal-title":"Am J Health Syst Pharm"},{"key":"R10-20260902","doi-asserted-by":"crossref","first-page":"7","DOI":"10.23822\/EurAnnACI.1764-1489.80","article-title":"Hypersensitivity reactions to non-vitamin K oral anticoagulants-A review of literature and diagnostic work-up proposal","volume":"51","author":"Carli","year":"2019","journal-title":"Eur Ann Allergy Clin Immunol"},{"key":"R11-20260902","doi-asserted-by":"crossref","first-page":"e9213","DOI":"10.1002\/ccr3.9213","article-title":"Hypersensitivity reaction to rivaroxaban with a successful switch to apixaban: A case report","volume":"12","author":"Mohammadi","year":"2024","journal-title":"Clin Case Rep"},{"key":"R12-20260902","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1177\/0897190017722872","article-title":"Probable rivaroxaban-induced full-body rash: A case report","volume":"31","author":"Sasson","year":"2018","journal-title":"J Pharm Pract"},{"key":"R13-20260902","doi-asserted-by":"crossref","first-page":"301","DOI":"10.4212\/cjhp.v70i4.1681","article-title":"Rivaroxaban-induced hypersensitivity syndrome","volume":"70","author":"Chiasson","year":"2017","journal-title":"Can J Hosp Pharm"},{"key":"R14-20260902","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.2147\/JAA.S413057","article-title":"Suspected rivaroxaban-induced anaphylaxis secondary to ingestion of rivaroxaban and nimesulide without cross-reactivity to dabigatran-a case report","volume":"16","author":"Gumbis","year":"2023","journal-title":"J Asthma Allergy"},{"key":"R15-20260902","first-page":"616109","article-title":"Dabigatran-associated leukocytoclastic vasculitis","author":"Potolidis","year":"2015","journal-title":"Case Rep Med 2015"},{"key":"R16-20260902","first-page":"38","article-title":"Delayed hypersensitivity to new oral anticoagulants. Demonstration of cross reactivity for the drug category and definition of non-irritant concentrations for patch tests","volume":"51","author":"Cortellini","year":"2019","journal-title":"Eur Ann Allergy Clin Immunol"},{"key":"R17-20260902","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1161\/CIRCULATIONAHA.121.056355","article-title":"Direct oral anticoagulants versus warfarin in patients with atrial fibrillation: patient-level network meta-analyses of randomized clinical trials with interaction testing by age and sex","volume":"145","author":"Carnicelli","year":"2022","journal-title":"Circulation"}],"container-title":["Indian Dermatology Online Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/idoj.idoj_1280_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T19:00:30Z","timestamp":1788375630000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/idoj.idoj_1280_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,18]]},"references-count":17,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/idoj.idoj_1280_25","relation":{},"ISSN":["2229-5178","2249-5673"],"issn-type":[{"value":"2229-5178","type":"print"},{"value":"2249-5673","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,18]]},"assertion":[{"value":"2025-10-23","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-26","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}