DOI QR코드

DOI QR Code

Nicolau Syndrome after Intramuscular Injection: 3 Cases

  • Kim, Seok-Kwun (Department of Plastic and Reconstructive Surgery, Dong-A University College of Medicine) ;
  • Kim, Tae-Heon (Department of Plastic and Reconstructive Surgery, Dong-A University College of Medicine) ;
  • Lee, Keun-Cheol (Department of Plastic and Reconstructive Surgery, Dong-A University College of Medicine)
  • Received : 2012.02.10
  • Accepted : 2012.04.17
  • Published : 2012.05.15

Abstract

Nicolau syndrome is a rare complication of intramuscular injection consisting of ischemic necrosis of skin, soft tissue, and muscular tissue that arises locoregionally. The characteristic pattern is pain around the injection site, developing into erythema, a livedoid dermatitis patch, and necrosis of the skin, subcutaneous fat, and muscle tissue. Three patients were injected with drugs (diclofenac sodium, ketoprofen, meperidine) for pain relief. Three patients complained of pain, and a skin lesion was observed, after which necrosis developed on their buttocks. Each patient underwent debridement and coverage. The wound healed uneventfully. We report three cases of Nicolau syndrome in the buttocks following diclofenac intramuscular injection.

Keywords

References

  1. Faucher L, Marcoux D. What syndrome is this? Nicolau syndrome. Pediatr Dermatol 1995;12:187-90. https://doi.org/10.1111/j.1525-1470.1995.tb00151.x
  2. McGee AM, Davison PM. Skin necrosis following injection of non-steroidal anti-inflammatory drug. Br J Anaesth 2002; 88:139-40. https://doi.org/10.1093/bja/88.1.139
  3. Corazza M, Capozzi O, Virgilit A. Five cases of livedo-like dermatitis (Nicolau's syndrome) due to bismuth salts and various other non-steroidal anti-inflammatory drugs. J Eur Acad Dermatol Venereol 2001;15:585-8. https://doi.org/10.1046/j.1468-3083.2001.00320.x
  4. Lee DP, Bae GY, Lee MW, et al. Nicolau syndrome caused by piroxicam. Int J Dermatol 2005;44:1069-70. https://doi.org/10.1111/j.1365-4632.2004.02534.x
  5. Cherasse A, Kahn MF, Mistrih R, et al. Nicolau's syndrome after local glucocorticoid injection. Joint Bone Spine 2003; 70:390-2. https://doi.org/10.1016/S1297-319X(03)00137-4
  6. Nagore E, Torrelo A, Gonzalez-Mediero I, et al. Livedoid skin necrosis (Nicolau syndrome) due to triple vaccine (DTP) injection. Br J Dermatol 1997;137:1030-1. https://doi.org/10.1111/j.1365-2133.1997.tb01585.x
  7. Taylor C, Lillis C, LeMone P, et al. Fundamentals of nursing: The art and science fo nursing care. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2006.

Cited by

  1. Nicolau's Syndrome Complicated by Atypical Necrotizing Fasciitis vol.40, pp.3, 2012, https://doi.org/10.5999/aps.2013.40.3.267
  2. NICOLAU SYNDROME: AN IATROGENIC COMPLICATION vol.3, pp.53, 2012, https://doi.org/10.14260/jemds/2014/3636
  3. Crushed and Injected Buprenorphine Tablets: Characteristics of Princeps and Generic Solutions vol.9, pp.12, 2012, https://doi.org/10.1371/journal.pone.0113991
  4. Coincidence of Nicolau Syndrome and Rhabdomyolysis: Report of a Forensic Autopsy Case and Review of the Literature vol.61, pp.5, 2012, https://doi.org/10.1111/1556-4029.13126
  5. Nicolau Syndrome due to Penicillin Injection: A Report of 3 Cases without Long-Term Complication vol.2016, pp.None, 2012, https://doi.org/10.1155/2016/9082158
  6. Post-injection embolia cutis medicamentosa - Nicolau Syndrome: case report and literature review vol.15, pp.1, 2012, https://doi.org/10.1590/1677-5449.008315
  7. Nicolau syndrome after lumbar puncture: A case report in a 22-month-old girl vol.3, pp.1, 2017, https://doi.org/10.1016/j.jdcr.2016.09.004
  8. A misplaced intramuscular injection and limb-threatening ischemia vol.6, pp.3, 2017, https://doi.org/10.4103/2249-4863.222058
  9. A Case Report of Nicolau Syndrome After Aesthetic Breast Surgery: A Review of the Literature and Introduction to a New Treatment Modality vol.2, pp.3, 2020, https://doi.org/10.1093/asjof/ojaa027
  10. Nicolau syndrome caused by non‐steroidal anti‐inflammatory drugs: Systematic literature review vol.74, pp.10, 2020, https://doi.org/10.1111/ijcp.13567
  11. Embolia Cutis Medicamentosa after Subcutaneous Injection with Glatiramer Acetate vol.13, pp.1, 2012, https://doi.org/10.1159/000510017