Sclerodermiform reaction to vitamin K Intramuscular injection Vit. K is followed by an erythematous plaque in the lumbosacral area, which takes on a dusky colour and becomes infiltrated and itchy after 10-15 days. After some months, it resembles a patch of scleroderma, ivory-white in colour with a surrounding lilac ring. Confluence of plaques in the trochanteric and lumbosacral area produces the so- called 'cowboy's belt' appearance, complete with holsters.