title: Livedoid dermatitis and severe necrosis (Nicolau's syndrome) after intramuscular hydroxyzine injection.
abstract: Nicolau's syndrome, also called embolica cutis medicamentosa, is characterized by well- circumscribed livedoid dermatitis with aseptic necrosis after intramuscular injection. We report the case of a 45-year-old woman with severe necrosis of the thigh several days after a routine intramuscular injection of hydroxyzine who was transferred to and treated at our Regional Burn Center. Although there has been one case report and numerous voluntarily reported instances of intramuscular hydroxyzine-induced necrosis to the Food and Drug Administration Spontaneous Reporting System, this phenomenon is rare.
authors.affiliation: University of Minnesota, Minneapolis, Minnesota 55101-2595, USA.
authors.forename: Jon
authors.initials: J
authors.lastname: Gayken
authors.forename: Anders
authors.initials: A
authors.lastname: Westanmo
authors.forename: Amy
authors.initials: A
authors.lastname: Knutsen
authors.forename: David H
authors.initials: DH
authors.lastname: Ahrenholz
authors.forename: William J
authors.initials: WJ
authors.lastname: Mohr
authors.forename: Lynn D
authors.initials: LD
authors.lastname: Solem
mesh_terms: D000982:Antipruritics / Q000008:administration & dosage / Q000009:adverse effects*; D003875:Drug Eruptions / Q000209:etiology*; D005260:Female; D006801:Humans; D006919:Hydroxyzine / Q000008:administration & dosage / Q000009:adverse effects*; D007273:Injections, Intramuscular; D008875:Middle Aged; D009336:Necrosis / Q000139:chemically induced; D012867:Skin / Q000473:pathology*; D013577:Syndrome; D013848:Thigh
chemical_list: D000982:Antipruritics; D006919:Hydroxyzine