vitamin-k-semiquinone-radical and Eczema

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

Hypoprothrombinemic states are commonly treated with injectable vitamin K. Cutaneous vitamin K hypersensitivity can manifest as eczematous or sclerodermoid lesions and historically has been related to the use of fat-soluble vitamin K1. We present a case of warfarin-induced hypoprothrombinemia treated with aqueous vitamin K1, which resulted in the appearance of eczematous vitamin K1 hypersensitivity.

Topics: Adult; Eczema; Female; Humans; Hypoprothrombinemias; Injections, Subcutaneous; Vitamin K

Topics: Adult; Dermatitis, Occupational; Eczema; Humans; Male; Skin Tests; Vitamin K; Vitamin K 3