To the Editor.—
We read with interest the article by Shmunes1 in the September Archives concerning allergic dermatitis to benzyl alcohol. The author implicated 1% benzyl alcohol as a perservative in sodium tetradecyl sulfate as being the cause for the development of tender, slightly pruritic, dermal plaques at the sites of injection sclerotherapy for varicose veins. The author listed the injectable agents containing benzyl alcohol, which included vitamin preparations.We have studied two patients with phytonadione skin hypersensitivity and find difficulty in accepting Shmunes' implication that benzyl alcohol is the allergen. This drug uses benzyl alcohol in a 0.9% concentration in the vehicle.
Report of Cases.—
A 64-year-old woman with mitral valvular heart disease had received 10 mg of phytonadione subcutaneously to reverse the effect of warfarin sodium prior to cardiac catheterization. Five days later the patient developed a pruritic erythematous indurated plaque at the site of injection. Subsequent