title: Five cases of livedo-like dermatitis (Nicolau's syndrome) due to bismuth salts and various other non-steroidal anti-inflammatory drugs.
abstract: The authors report five cases of Nicolau's syndrome observed over a period of about 25 years. The disease had occurred after intramuscular injections of different drugs (bismuth, diclofenac and ibuprofen). In all the described cases the clinical aspect was characterized by a livedoid pattern followed by a slow necrotizing evolution with scar formation; in some cases surgical debridement and plastic reconstructive surgery were performed. In the past Nicolau's syndrome was described after intramuscular injections of bismuth salts for the treatment of syphilis; now, although still rare, it is described after injections of various aqueous drug solutions. The pathogenesis of Nicolau's dermatitis appears to be more complex than the previous hypothesized embolism caused by oleous drugs.
authors.affiliation: Dipartimento di Medicina Clinica e Sperimentale-Sezione Dermatologia, Università di Ferrara, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Corazza
authors.forename: O
authors.initials: O
authors.lastname: Capozzi
authors.forename: A
authors.initials: A
authors.lastname: Virgilit
mesh_terms: D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use*; D001729:Bismuth / Q000009:adverse effects* / Q000627:therapeutic use; D003875:Drug Eruptions / Q000150:complications / Q000209:etiology* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D018570:Risk Assessment; D012720:Severity of Illness Index; D012883:Skin Ulcer / Q000139:chemically induced* / Q000150:complications / Q000473:pathology; D013577:Syndrome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D001729:Bismuth