Three cases of embolia cutis medicamentosa (Nicolau's syndrome).
Embolia cutis medicamentosa, also known as Nicolau's syndrome, is a rare complication due to i.m. injections. Its real incidence is actually underestimated. Many drugs have been associated with it, but at the time only a few studies showed a related pathogenetic mechanism. Symptoms consist of immediate local pain, edema and cutaneous, subcutaneous and even muscular necrosis occurring in the first 48 h. The type of treatment depends mostly on time of diagnosis. A medical resolution can be achieved through heparin and cortisone injections within the first 48 h. Surgical debridement has to be considered as the main treatment in case of late diagnosis. We present three cases of Nicolau's syndrome presenting to us in a short period of time that we treated with surgical debridement.
Marangi
Giovanni Francesco
GF
Plastic and Reconstructive Surgery, Campus Bio-Medico di Roma University, Rome, Italy. g.marangi@unicampus.it
Gigliofiorito
Pierluigi
P
Toto
Vito
V
Langella
Marika
M
Pallara
Tiziano
T
Persichetti
Paolo
P
D000368:Aged; D004008:Diclofenac / Q000009:adverse effects; D005218:Fat Necrosis / Q000139:chemically induced* / Q000473:pathology; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D020910:Ketorolac / Q000009:adverse effects; D008875:Middle Aged; D009336:Necrosis / Q000139:chemically induced / Q000473:pathology; D012867:Skin / Q000473:pathology*; D013577:Syndrome
D004008:Diclofenac; D020910:Ketorolac