Recalcitrant adverse reaction to vitamin K: response to pulsed dye laser

Adverse cutaneous reaction to vitamin K manifests in sclerodermatous or erythematous plaque-like reactions. Most of the cases with erythematous plaque-like dermatitis arising at the site of intramuscular vitamin K injection were recalcitrant and did not respond to various attempts with topical and intralesional corticosteroid.

The objective was to describe a 25-year-old woman with recalcitrant adverse reaction owing to vitamin K who was successfully treated with pulsed dye laser.

Two consecutive pulsed dye laser treatments were performed 3 weeks apart with 450-microec pulse duration, 585-nm pulse width, and fluence of 5 and 7 J/cm(2), respectively, using a 7-mm handpiece.

One week after the second treatment, her skin lesion was cleared and she was followed without recurrence for 7 months.

Although the precise mechanism remains yet to be proven, we have demonstrated successful treatment of localized adverse cutaneous reaction to vitamin K in one patient with the pulsed dye laser.