title: Nicolau syndrome and perforator vessels: a new viewpoint for an old problem.
abstract: Nicolau syndrome is rare cutaneous adverse reaction following injection of various drugs. The disease has been associated with almost all classes of medications, such as nonsteroidal anti-inflammatory drugs, local anesthetics, corticosteroids, antibiotics, vitamin B complexes, antihistamines, and vaccines. The most severe cases of this complication occur after injection of nonsteroidal anti-inflammatory drugs. Subcutaneous injection is an important factor in the pathogenesis of the syndrome. We report a case of Nicolau syndrome resulting from intramuscular injection of diclofenac and discuss some precautions to prevent this complication.
authors.affiliation: Medical Park Bahcelievler Hospital, Department of Dermatology, Istanbul, Turkey. gokhanokan8@hotmail.com
authors.forename: Gokhan
authors.initials: G
authors.lastname: Okan
authors.forename: Halil Ibrahim
authors.initials: HI
authors.lastname: Canter
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects*; D003646:Debridement; D004008:Diclofenac / Q000008:administration & dosage / Q000009:adverse effects*; D003875:Drug Eruptions / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D009336:Necrosis; D009779:Occlusive Dressings; D016038:Skin Transplantation; D040521:Subcutaneous Tissue / Q000098:blood supply*; D013577:Syndrome; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004008:Diclofenac