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Cutaneous reactions to vitamin K1 injections
1Department of Dermatology, New York Medical College, Metropolitan Hospital Center, New York.
Journal of the American Academy of Dermatology
|February 1, 1993
Summary
Vitamin K1 injections can cause skin reactions, even without liver disease. These reactions present as red patches at the injection site, indicating hypersensitivity is possible in various patient groups.
Area of Science:
- Dermatology
- Clinical Pharmacology
- Hepatology
Background:
- Cutaneous reactions to vitamin K1 (phylloquinone) injections are uncommon.
- Previous reports predominantly linked these reactions to underlying liver disease, such as alcoholic cirrhosis and viral hepatitis.
Observation:
- Four new cases of cutaneous reactions to vitamin K1 injections were observed.
- One patient presented with polycythemia vera and Budd-Chiari syndrome.
- The remaining three patients had no diagnosed hepatic disease.
Findings:
- Reactions manifested as erythematous plaques at the injection site, without progressing to sclerodermatous changes.
- Histopathology revealed spongiotic changes and mononuclear infiltrates, characteristic of vitamin K1 hypersensitivity.
- One case showed a neutrophilic infiltrate at the reaction site.
Implications:
- These findings challenge the necessity of pre-existing liver disease for vitamin K1 hypersensitivity.
- Clinicians should consider vitamin K1 hypersensitivity in patients presenting with injection site reactions, irrespective of liver status.
- Further investigation into the mechanisms of vitamin K1-induced cutaneous reactions is warranted.