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- W4387014226 abstract "Nicolau syndrome is an uncommon complication associated with parenteral, mainly intramuscular, administration of medications. A variety of agents have been implicated, such as nonsteroidal anti- inflammatory drugs and antibiotics. It is characterized by acute pain and erythema around the injection site of the which rapidly evolves into livedoid reticular or hemorrhagic patches, and less commonly to ulcers and skin necrosis. Various mechanisms have been proposed in the past years, being peripheral arterial occlusion due to direct or indirect vessel damage the most accepted hypothesis. We present two patients who had a sudden post-injection inflammatory response consistent with Nicolau syndrome associated to diclofenac, a common drug that was applied by family members. Our first case, a 61-year old female who developed intense pain and erythema over her abdomen, right buttock and lower extremity after multiple diclofenac injections intramuscularly. Biopsy revealed focal epidermal necrosis with congestion and vascular ectasia. The second case, a 34-year old female who developed edema, intense pain, and erythematous nodule with necrotic crust in the right buttock after intramuscular application. Conservative treatment was stablished with development of atrophic scars in the affected areas. Nicolau syndrome is a rare adverse reaction to the administration of intramuscular drugs characterized by ischemic necrosis of the skin and deeper tissue. These cases illustrate the particular importance of this condition as an iatrogenic complication. Measures such as aspirating just before injecting and intramuscular drug administration only by healthcare workers is suggested as prevention." @default.
- W4387014226 created "2023-09-26" @default.
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- W4387014226 date "2023-09-01" @default.
- W4387014226 modified "2023-10-10" @default.
- W4387014226 title "43699 Two cases of Nicolau syndrome: an avoidable entity" @default.
- W4387014226 doi "https://doi.org/10.1016/j.jaad.2023.07.407" @default.
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