Pang B K, Munro V, Kossard S
Department of Dermatology, St Vincent's Hospital, Darlinghurst, New South Wales, Australia.
Australas J Dermatol. 1996 Feb;37(1):44-7. doi: 10.1111/j.1440-0960.1996.tb00994.x.
Cutaneous reactions to vitamin K1 (phytomenadione) are uncommon. They can present as acute eczematous reactions or late reactions that resemble localized scleroderma after vitamin K1 injections. A case is reported here of a patient who developed bilateral sclerodermoid plaques in a cowboy's holster pattern, which persisted for more than 10 years after subcutaneous vitamin K1 injections. Positive intradermal test with vitamin K1 that persisted as an erythematous indurated plaque at the test site for more than 5 months confirmed marked cutaneous hypersensitivity to vitamin K1 in this patient. Serial biopsies of the erythematous plaque at the test site showed transition from spongiotic eczematous features initially to inflammatory morphoea-like histology over a 5 month period. Possible pathogenic mechanisms for phytomenadione-induced pseudoscleroderma are discussed.
皮肤对维生素K1（植物甲萘醌）的反应并不常见。它们可表现为急性湿疹样反应或维生素K1注射后类似局限性硬皮病的迟发性反应。本文报告了1例患者，在皮下注射维生素K1后出现双侧呈牛仔皮套样的硬皮病样斑块，这些斑块在注射后持续存在了10多年。维生素K1皮内试验呈阳性，试验部位的红斑硬结斑块持续超过5个月，证实该患者对维生素K1存在明显的皮肤超敏反应。对试验部位红斑斑块的系列活检显示，在5个月的时间里，最初的海绵状湿疹样特征逐渐转变为炎症性硬斑病样组织学特征。文中讨论了植物甲萘醌诱导假性硬皮病的可能致病机制。
