Internal Medicine

0521779407-22 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:23

Vitamin K Deficiency Vitiligo 1539

tests

Laboratory

■Basic blood studies:

➣PT, INR, PTT prolonged

differential diagnosis

■Warfarin use

■Liver disease

■Dysfibrinogenemia

■Lupus anticoagulant

■Factors V, X, II deficiency

■Disseminated intravascular coagulation

management

n/a

specific therapy

■phytonadione IM (can use IV in emergencies, do not exceed 1

mg/min); response detectable within 1–2 hours

Side Effects & Contraindications

■None

follow-up

n/a

complications and prognosis

■Reversible with replacement

VITILIGO

KAREN GOULD, MD and

JEFFREY P. CALLEN, MD

history & physical

History

■autoimmune mechanism with genetic predisposition likely

cause

➣possible environmental triggers are trauma sun exposure, sys-

temic illness

➣1–2% population