title: Nicolau syndrome due to hyaluronic acid injections.
abstract: Six cases of vascular compromise after hyaluronic injection are reported. Clinical symptoms realized a Nicolau syndrome, which is characterized by immediate pain, livedoid pattern and a few days later by the appearance of scabs and skin necrosis. This type of complication is rare, but may be dramatic and injectors must be aware of that. A thorough knowledge of facial anatomy is mandatory to avoid the risky facial areas. The use of a flexible cannula instead of a sharp needle has much less risk of hurting vessels and must be preferred. The support of the patient is discussed and a treatment protocol is proposed.
authors.affiliation: a Paris , France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Andre
authors.affiliation: b Department of Dermatol , Inselspital , Bern , Switzerland.
authors.forename: Eckart
authors.initials: E
authors.lastname: Haneke
mesh_terms: D000328:Adult; D003357:Cosmetic Techniques / Q000009:adverse effects*; D000067548:Dermal Fillers / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage / Q000009:adverse effects*; D007279:Injections, Subcutaneous / Q000009:adverse effects; D008875:Middle Aged; D065148:Nicolau Syndrome / Q000209:etiology*
chemical_list: D000067548:Dermal Fillers; D006820:Hyaluronic Acid
keywords: Filler complications; hyaluronic acid; hyaluronidase; intra-arterial injection; nicolau syndrome