Department of Dermatology, University of Naples Federico II, Naples, Italy.
G Ital Dermatol Venereol. 2012 Apr;147(2):203-5.
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.
维生素 K1（植物甲萘醌或叶绿醌）是一种脂溶性维生素，用于治疗某些凝血障碍。维生素 K1 肌内注射偶尔会引起不同类型的皮肤反应：注射部位出现红斑性斑块、荨麻疹样皮疹或硬皮病样病变。我们报告了一例 52 岁男性的病例，他表现为 2 个对称的红斑浸润性硬皮病样斑块，位于右、左下躯干。为了纠正因 HCV+肝炎导致的低凝血酶原血症引起的凝血缺陷，患者接受了维生素 K1 治疗，每天肌内注射（10mg 维生素 K1/1ml）一次，持续 2 周。治疗中断 3 个月后，在注射部位出现象牙色硬结的硬皮病样斑块，呈现出“牛仔皮带配左轮手枪”的典型外观。维生素 K1 停药 2 年后，硬皮病样病变仍持续存在。我们报告这个病例是为了强调维生素 K1 注射偶尔会引起不同类型的皮肤反应，如硬皮病样斑块。由于发病延迟、临床表现多样、治疗中断后持续存在，这种病变可能构成棘手的诊断挑战，尽管采用了不同的治疗方法，但仍可能持续多年。
