Nicolau syndrome in an athlete following intra-muscular diclofenac injection.
Nicolau Syndrome (also known as Embolia cutis medicamentosa and livedo-like dermatitis) is a rare but severe localized adverse drug reaction to a range of intra-muscular preparations. It manifests as acute pain, cutaneous, subcutaneous and intra-muscular inflammation and necrosis immediately following an injection, with potentially devastating sequelae. We describe the syndrome in a 21-year-old national level race walk athlete following an intramuscular diclofenac injection.
Hamilton
Bruce
B
Aspetar Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar. bruce.hamilton@aspetar.com
Fowler
Peter
P
Galloway
Howard
H
Popovic
Nebojsa
N
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects*; D000925:Anticoagulants / Q000627:therapeutic use; D004008:Diclofenac / Q000008:administration & dosage / Q000009:adverse effects*; D003875:Drug Eruptions; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D007273:Injections, Intramuscular; D008279:Magnetic Resonance Imaging; D008297:Male; D009336:Necrosis; D017445:Skin Diseases, Vascular / Q000139:chemically induced*; D013177:Sports; D013577:Syndrome; D016138:Walking
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D004008:Diclofenac