vitamin-k-semiquinone-radical and Dermatitis--Allergic-Contact

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

LMWHs are the major anticoagulant/antithrombotic treatment given to pregnant women to prevent and treat venous thromboembolism despite the absence of specific clinical trials. An emerging indication, the prevention of adverse pregnancy outcomes, is under investigation. During pregnancy, LMWHs seem to be safe and efficient. Some uncertainties remain about the management of rare potential side effects, particularly in the event of heparin intolerance and with cross-reactivity to danaparoid sodium.

Topics: Abnormalities, Drug-Induced; Anticoagulants; Contraindications; Dermatitis, Allergic Contact; Female; Fibrinolytic Agents; Hemorrhage; Heparin; Humans; Pregnancy; Pregnancy Complications, Hematologic; Thrombocytopenia; Thrombophilia; Venous Thrombosis; Vitamin K

Topics: Administration, Cutaneous; Adult; Dermatitis, Allergic Contact; Diagnosis, Differential; Facial Dermatoses; Female; Humans; Hyperpigmentation; Patch Tests; Vitamin K

Topics: Allergens; Dermatitis, Allergic Contact; Female; Follow-Up Studies; Humans; Hypersensitivity, Immediate; Hypoprothrombinemias; Injections, Intramuscular; Middle Aged; Patch Tests; Risk Assessment; Sensitivity and Specificity; Vitamin K; Vitamin K 1

The day after intramuscular injection of vitamin K1 (phytomenadione) into her thigh, a 27-year-old-woman with normal liver function developed a relapsing and remitting eczematous reaction localized to the injection site, and later a further eczematous reaction under an adhesive dressing (Duoderm). On patch testing, she was positive to vitamin K1 and cross-reacted to vitamin K4; she was also positive to colophonium and to ester gum rosin, the dressing adhesive. Recurrent angioedema persisted for several months and, 2 years later, symptoms were still occurring over the injection sites. Structure-activity relationships among vitamin K allergens are discussed.

Topics: Adult; Dermatitis, Allergic Contact; Eczema; Female; Humans; Injections, Intramuscular; Molecular Conformation; Patch Tests; Vitamin K