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)
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 o...
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.
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.
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제안 방법
Histologic findings were superficial and deep perivascular dermatitis with vaculolar change in the epidermis and vasculitis were identified. The authors performed an excision and covered it with a bilateral advancement flap. The wound healed uneventfully.
Among the drugs associated with this syndrome, nonsteroidal anti-inflammatory drugs in particular have rare, severe complications of intramuscular injection leading to necrosis of the skin, subcutaneous tissue, and muscle tissue. The authors report three cases of Nicolau syndrome after diclofenac intramuscular injection.
대상 데이터
A 36-year-old man was injected with Demerol (meperidine) every 3 hours during 4 days for operation site pain. After the injections, the patient complained of pain and an erythematous lesion was seen.
A 79-year-old female patient was injected with ketoprofen for knee pain relief. After the injection, she experienced severe pain and hardness at the injection site.
참고문헌 (7)
1 Faucher L Marcoux D What syndrome is this? Nicolau syndrome Pediatr Dermatol 1995 12 187 190 7659650
2 McGee AM Davison PM Skin necrosis following injection of non-steroidal anti-inflammatory drug Br J Anaesth 2002 88 139 140 11881870
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 15 585 588 11843224
4 Lee DP Bae GY Lee MW Nicolau syndrome caused by piroxicam Int J Dermatol 2005 44 1069 1070 16409285
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