vitamin-k-1 and Erythema

Between 1964 and 1994, at least 52 patients with cutaneous adverse effects of vitamin K have been described in the European and North American literature. A review of the details of these patients is given and 2 new cases reported. Adverse effects are seen not only in patients with liver-function disturbances but also in patients without liver diseases, and occur mostly after intramuscular or subcutaneous administration of vitamin K1, independent of the total dose. Patch and intracutaneous tests often give positive reactions. The mechanism of action is probably in many patients a delayed-type hypersensitivity reaction.

Topics: Adolescent; Adult; Aged; Child; Dermatitis, Allergic Contact; Dermatitis, Contact; Erythema; Europe; Female; Humans; Injections; Intradermal Tests; Liver Diseases; Male; Middle Aged; Patch Tests; United States; Vitamin K; Vitamin K 1

Vitamin K1 (phytomenadione or phytonadione) is a fat soluble vitamin used to treat certain coagulation disorders. Intra muscular injection of vitamin K1 can occasionally be complicated by different types of skin reactions: erythematous plaques, urticarial rashes or scleroderma-like lesions at the injection site. We report the case of a 52-year-old man presenting with 2 symmetrical erythematous-infiltrated scleroderma-like plaques localized on the right and left lower trunk. To correct the coagulation deficiency with hypoprothrombinemia developed as a consequence of HCV+ hepatitis, the patient was on vitamin K1 therapy, administered by i.m. injection (10 mg Vitamin K1/1 ml) once a day for 2 weeks. Three months after treatment interruption, ivory indurated morphoeiform plaques developed at the injection sites, assuming the typical appearance of a "cowboy's belt with revolver". The scleroderma-like lesions persisted 2 years after vitamin K1 withdrawal. We report this case to highlight the possibility that vitamin K1 injections can occasionally be complicated by different types of skin reactions such as sclerodermatous plaques. Due to the delay in the onset, to the variable clinical picture, to the persistence after therapy interruption, this kind of lesions can represent a tricky diagnostic challenge and in spite of different treatments can endure for years.

Topics: Diabetes Mellitus, Type 2; Erythema; Hepatitis C, Chronic; Humans; Hypoprothrombinemias; Injections, Intramuscular; Male; Middle Aged; Scleroderma, Localized; Vitamin K 1

Vitamin K1 is frequently used in the treatment and prevention of hypoprothrombinemia and hemorrhagic disease of the newborn. It also serves as an antidote to anticoagulants. Erythematous, indurated, pruritic plaques uncommonly occur in adults after intramuscular injection with vitamin K1. We present a case of a localized cutaneous reaction to intramuscular vitamin K1 in a peripartum patient with acute fatty liver of pregnancy. The history and clinical presentation of our case is presented with a discussion of the pathogenesis pathogenesis of vitamin K1 and available treatment for this condition.

Topics: Acute Disease; Drug Eruptions; Drug Hypersensitivity; Eczema; Erythema; Fatty Liver; Female; Humans; Hypoprothrombinemias; Injections, Intramuscular; Pregnancy; Pregnancy Complications; Puerperal Disorders; Vitamin K 1; Young Adult

Topics: Dermatitis, Atopic; Drug Eruptions; Drug Hypersensitivity; Erythema; Humans; Hypersensitivity, Immediate; Injections, Subcutaneous; Liver Cirrhosis, Alcoholic; Male; Middle Aged; Vitamin K 1

Two patients with erythematous, tender, indurated plaques at the site of intramuscular injections of vitamin K1 are described. In one of these, condition was reproduced by the injection of a test dose. In both cases, there was associated liver disease. The red, indurated plaques cleared in 4-14 days. There have been two previous reports in the literature of similar lesions. Altough some of the patients showed sclerodermatous changes at the same site within 2 years of the injections. These unusual reactions have only been seen in patients with liver disease and when a variety of drugs have been administered. It may be that these factors are important in the initiation of the cutaneous response.

Topics: Adult; Erythema; Female; Humans; Injections, Intramuscular; Liver Diseases; Vitamin K 1

Topics: Buttocks; Erythema; Female; Humans; Injections, Intramuscular; Liver Cirrhosis; Male; Microscopy, Electron; Middle Aged; Scleroderma, Localized; Skin; Vitamin K 1

Topics: Collagen; Drug Combinations; Erythema; Humans; Injections, Intramuscular; Ketoglutaric Acids; Liver Extracts; Lumbosacral Region; Ornithine; Scleroderma, Localized; Vitamin K 1

Topics: Acetylcholine; Aerosols; Albumins; Anaphylaxis; Animals; Anti-Inflammatory Agents; Bradykinin; Bronchial Spasm; Edema; Erythema; Exudates and Transudates; Female; Gossypium; Granuloma; Guinea Pigs; Histamine; History of Medicine; In Vitro Techniques; Inflammation; Irritants; Kaolin; Lung; Male; Prednisolone; Rats; Serotonin; Ultraviolet Rays; Vitamin K; Vitamin K 1