Adverse skin reaction from vitamin KI

Two patients with erythematous, tender, indurated plaques at the site of intramuscular injections of vitamin K1 are described. In one of these, the condition was reproduced by the injection of a test dose. In both cases, there was associated liver disease. The red, indurated plaques cleared in 4–14 days.

There have been two previous reports in the literature of similar lesions, although some of the patients showed sclerodermatous changes at the same site within 2 years of the injections. These unusual reactions have only been seen in patients with liver disease and when a variety of drugs have been administered. It may be that these factors are important in the initiation of the cutaneous response.

Severe local reactions due to intramuscular injections of vitamins are rare and the few cases reported do not conform to a uniform pattern. This is a report of two patients with liver disease who developed localized red, tender, infiltrated plaques 4–14 days after intramuscular injections of vitamin K1. The lesions persisted for 2 months but settled without leaving permanent scarring.