Nicolau Syndrome

An uncommon complication of INTRAMUSCULAR INJECTION leading to variable degrees of necrosis of skin and underlying tissue.

Also Known As:

Embolia Cutis Medicamentosa; Livedo-like Dermatitis; Nicolau Livedoid Dermatitis; Nicolau's Livedoid Syndrome; Nicolau's Syndrome; Cutis Medicamentosa, Embolia; Dermatitides, Livedo-like; Dermatitis, Livedo-like; Dermatitis, Nicolau Livedoid; Livedo like Dermatitis; Livedo-like Dermatitides; Livedoid Dermatitis, Nicolau; Livedoid Syndrome, Nicolau's; Medicamentosa, Embolia Cutis; Nicolau Livedoid Syndrome; Nicolaus Livedoid Syndrome; Nicolaus Syndrome; Syndrome, Nicolau; Syndrome, Nicolau's; Syndrome, Nicolau's Livedoid

Networked: 145 relevant articles (1 outcomes, 0 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Nicolau Syndrome
2.	Necrosis
3.	Pain (Aches)
4.	Injection Site Reaction
5.	Dermatitis

Experts

1.	Bianchetti, Mario G: 2 articles (01/2022 - 10/2020)
2.	Lardelli, Pietro F: 2 articles (01/2022 - 10/2020)
3.	Lava, Sebastiano A G: 2 articles (01/2022 - 10/2020)
4.	Milani, Gregorio P: 2 articles (01/2022 - 10/2020)
5.	Arif, Tasleem: 2 articles (07/2018 - 10/2017)
6.	Espitia, O: 2 articles (01/2017 - 01/2015)
7.	Mancano, Michael A: 2 articles (07/2016 - 01/2015)
8.	Aractingi, S: 2 articles (05/2004 - 05/2003)
9.	Duco, Marissa R: 1 article (12/2022)
10.	Murdock, Joshua L: 1 article (12/2022)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Nicolau Syndrome:

1.	Oxygen (Dioxygen)IBA 06/30/2022 - "The objectives of this case series are to analyse the role, timing and efficacy of hyperbaric oxygen treatment (HBOT) in the management of Nicolau syndrome (NS), an extremely rare complication of this common intervention. " 06/30/2022 - "Hyperbaric oxygen treatment in a rare complication of intramuscular injection: four cases of Nicolau syndrome."
2.	Diclofenac (SR 38)FDA LinkGeneric 09/22/2023 - "Extensive Nicolau syndrome following intramuscular diclofenac sodium injection." 04/01/2023 - "Nicolau syndrome following Intramuscular Diclofenac Injection: a case report and review of the literature." 04/01/2020 - "Nicolau syndrome (NS) is a rare complication that develops after the administration of intramuscular diclofenac sodium. " 01/01/2020 - "We present an observational study of diclofenac induced Nicolau syndrome." 01/01/2020 - "Intramuscular diclofenac is a cause of Nicolau syndrome in obese women: An observational study of consecutive ten patients."
3.	Penicillin G Benzathine (Benzathine Benzylpenicillin)FDA Link 01/01/2020 - "Nicolau syndrome following intramuscular benzathine penicillin injection: a case report." 11/01/2014 - "Nicolau syndrome after intramuscular benzathine penicillin injection." 12/15/2010 - "Nicolau livedoid dermatitis following intramuscular benzathine penicillin injection." 10/01/2008 - "Nicolau syndrome following intramuscular benzathine penicillin." 08/01/2006 - "We describe a 3-year-old boy with diagnosis of Nicolau syndrome after intramuscular benzathine penicillin injection to the midanterior part of the left thigh. "
4.	Glatiramer Acetate (Copaxone)FDA Link 03/01/2023 - "We report a case of a 26-year-old woman with a history of a purple lesion on her thigh who was diagnosed with Nicolau syndrome due to subcutaneous administration of glatiramer acetate. " 03/01/2023 - "Nicolau Syndrome Secondary to Subcutaneous Glatiramer Acetate Injection." 01/01/2022 - "Additionally, the present systematic review of the literature documents 20 cases of Nicolau syndrome following glatiramer, a rare but potentially severe skin reaction. " 01/01/2022 - "Nicolau syndrome caused by Glatiramer." 11/01/2021 - "Nicolau syndrome following subcutaneous glatiramer acetate injection: A case report and review of the literature."
5.	Penicillins (Penicillin)FDA Link 01/01/2016 - "Nicolau Syndrome due to Penicillin Injection: A Report of 3 Cases without Long-Term Complication." 01/01/2012 - "Nicolau syndrome following intramuscular penicillin injection." 03/01/1998 - "The Authors, who in 1977 published the first Italian case report of the Nicolau syndrome (N.S.) from penicillin preparations in the pediatric field, accomplished a thorough search for similar reports in the world literature finding a total of 102 cases, of whom 80 were less than 12-year old. " 03/01/1998 - "[Nicolau syndrome caused by penicillin preparations: review of the literature in search for potential risk factors]." 01/01/2016 - "We report a case of Nicolau syndrome in a 15 months old girl following an intramuscular injection of penicillin 6.3.3 in her left buttock. "
6.	Adrenal Cortex Hormones (Corticosteroids)IBA 01/01/2011 - "We describe a case of late development of Nicolau syndrome following intra-articular infiltration with corticosteroid." 01/01/2005 - "Tachon's syndrome might be the venous counterpart of Nicolau's syndrome (injection of corticosteroids in an artery)." 01/01/2020 - "There are many medications reported as causative factors inducing Nicolau syndrome including penicillin, nonsteroidal anti-inflammatory drugs, corticosteroids, local anesthetics, and several others. " 12/01/2022 - "Nicolau syndrome has been reported with other non-vesicant, injectable medications such as antibiotics and corticosteroids; however, it has not been previously reported with fulvestrant. " 10/01/2017 - "Dear Editor, Nicolau's syndrome, also called embolia cutis medicamentosa or livedoid dermatitis, is a rare injection site reaction characterized by immediate intense pain at the injection site followed by erythema and a hemorrhagic patch with a livedoid reticular pattern after injections of non-steroidal anti-inflammatory drugs (NSAIDS), antiepileptics, antibiotics, antihistaminics, corticosteroids, etc. (1). "
7.	Anti-Bacterial Agents (Antibiotics)IBA 01/01/2023 - "Regarding the drugs classes that caused Nicolau syndrome, these were intravenous antibiotics in 57%, and non-steroidal anti-inflammatory drugs in 43% of cases. " 12/01/2022 - "Nicolau syndrome has been reported with other non-vesicant, injectable medications such as antibiotics and corticosteroids; however, it has not been previously reported with fulvestrant. " 10/01/2017 - "Dear Editor, Nicolau's syndrome, also called embolia cutis medicamentosa or livedoid dermatitis, is a rare injection site reaction characterized by immediate intense pain at the injection site followed by erythema and a hemorrhagic patch with a livedoid reticular pattern after injections of non-steroidal anti-inflammatory drugs (NSAIDS), antiepileptics, antibiotics, antihistaminics, corticosteroids, etc. (1). " 01/01/2023 - "Nicolau syndrome is commonly seen in patients after intramuscular, intra-articular, or subcutaneous injections of non-steroidal anti-inflammatory drugs, antiepileptics, antipsychotics, antibiotics, antihistamines, and corticosteroids. "
8.	GlucocorticoidsIBA 09/01/2014 - "Livedoid dermatitis (Nicolau syndrome) following intra-articular glucocorticoid injection." 09/01/2003 - "Nicolau's syndrome after local glucocorticoid injection." 09/01/2003 - "We report three cases of Nicolau's syndrome induced by intraarticular glucocorticoid injections. " 01/01/2015 - "Patient with terbinafine-induced subacute cutaneous lupus erythematosus followed by thalidomide-induced orofacial neuropathy; Beta blocker use, hypertension, and the risk of psoriasis; eczematous reaction to intravenous immunoglobulin; nicolau syndrome after intra-articular glucocorticoid injection; troponin leak associated with drug-induced methemoglobinemia."
9.	BismuthIBA 10/01/2020 - "This very uncommon but potentially severe reaction, termed Nicolau syndrome, is traditionally associated with bismuth and β-lactam antimicrobials. " 10/01/2017 - "Nicolau syndrome was first described in the early 1920s by Freudenthal and Nicolau as an adverse effect of using intramuscular injections of bismuth salts in the treatment of syphilis. " 11/01/2001 - "In the past Nicolau's syndrome was described after intramuscular injections of bismuth salts for the treatment of syphilis; now, although still rare, it is described after injections of various aqueous drug solutions. " 11/01/2001 - "Five cases of livedo-like dermatitis (Nicolau's syndrome) due to bismuth salts and various other non-steroidal anti-inflammatory drugs."
10.	Non-Steroidal Anti-Inflammatory Agents (NSAIDs)IBA 01/08/2015 - "Nicolau syndrome after intramuscular injection of non-steroidal anti-inflammatory drugs (NSAID)." 09/01/2005 - "Numerous clinical pictures involving the skin--various morbilliform rashes, urticaria and angioedema as the most common--due to hypersensitivity to a particular NSAID (i.e., ibuprofen) have been described; other clinically defined skin diseases such as vasculitis, Steven-Johnson's syndrome, photosensitivity, fixed drug eruptions, livedo-like dermatitis, linear drug eruption, lichenoid drug eruption, exanthematous pustulosis, eczematous eruption, contact dermatitis and pemphigoid have received the attention of physicians. " 10/01/2017 - "Dear Editor, Nicolau's syndrome, also called embolia cutis medicamentosa or livedoid dermatitis, is a rare injection site reaction characterized by immediate intense pain at the injection site followed by erythema and a hemorrhagic patch with a livedoid reticular pattern after injections of non-steroidal anti-inflammatory drugs (NSAIDS), antiepileptics, antibiotics, antihistaminics, corticosteroids, etc. (1). "

Therapies and Procedures

1.	Intramuscular Injections 04/01/2021 - "Nicolau Syndrome: An Unforeseen Yet Evadable Consequence of Intramuscular Injection." 07/01/2019 - "Nicolau syndrome is a very rare complication of intramuscular injection presumed to be related to the inadvertent intravascular injection. " 01/01/2019 - "Nicolau Syndrome: A Rare Complication following Intramuscular Injection." 06/01/2017 - "This case underlines the need to prevent Nicolau syndrome by means of compliance with the technical recommendations for intramuscular injections." 01/01/2016 - "Nicolau syndrome (NS) is a dermatological adverse reaction of intramuscular injections and is caused by several mechanisms. "
2.	Injections 03/01/2023 - "This case suggests that physicians should have a high index of suspicion for the presence of Nicolau syndrome in patients presenting with necrotic or ulcerative lesions with a history of using injectable drugs." 03/01/2023 - "Nicolau syndrome (NS) is a rare cutaneous drug reaction in response to injections administered via any route. " 01/01/2023 - "In conclusion, Nicolau syndrome is a rare side effect of injectable drug administration." 11/01/2021 - "Nicolau syndrome is a rare serious drug reaction associated with the administering various injectable medications. " 10/01/2020 - "Although Nicolau syndrome is extremely uncommon, physicians must be aware of this complication after intramuscular administration of non-steroidal anti-inflammatory drugs and should avoid unnecessary injections."
3.	Subcutaneous Injections 01/01/2021 - "Administration of intramuscular, intraarterial or subcutaneous injection of particular drugs ends up into a rare entity known as Nicolau syndrome (NS). " 06/01/2016 - "Nicolau syndrome (NS) is a rare complication of intramuscular, intraarticular or subcutaneous injection of particular drugs leading to ischemic necrosis of the surrounding skin, soft tissue and muscular tissue. " 06/01/2017 - "Nicolau syndrome is a rare condition consisting in tissue ischemia and necrosis following intramuscular, intra-articular or subcutaneous injection. " 12/14/2012 - "Nicolau syndrome-also known as Embolia Cutis Medicamentosa-is a rare complication of intramuscular and subcutaneous injections manifesting as necrosis of skin and the underlying tissues. " 01/01/2021 - "Embolia Cutis Medicamentosa after Subcutaneous Injection with Glatiramer Acetate."
4.	Sclerotherapy 10/01/2014 - "Nicolau livedoid dermatitis occurring after sclerotherapy." 01/01/2010 - "[The Nicolau syndrome as a complications of sclerotherapy for veins of the lower extremities]." 03/01/1999 - "Embolia cutis medicamentosa of the foot after sclerotherapy." 09/01/2014 - "Nicolau syndrome following sclerotherapy for pyogenic granuloma." 05/01/2004 - "Nicolau livedoid dermatitis during sclerotherapy of a varicose vein has rarely been described before. "
5.	Intra-Articular Injections 03/01/1999 - "We describe the occurrence of embolia cutis medicamentosa after intra-articular injections into the knee." 01/01/2021 - "Embolia cutis medicamentosa (ECM) is a rare and unpredictable injection site reaction, occurring after intramuscular, subcutaneous, and even after intraarticular injection of various drugs. " 08/12/2020 - "Nicolau syndrome, also known as livedo-like dermatitis or embolia cutis medicamentosa, is a rare complication usually after intra-muscular or intra-articular injection of various drugs. " 12/04/2014 - "Nicolau syndrome, also known as livedo-like dermatitis or embolia cutis medicamentosa, is a rare complication following the intramuscular or intra-articular injection of various drugs. " 12/01/2009 - "Nicolau syndrome (NS), also known as livedo-like dermatitis or embolia cutis medicamentosa, is a very rare complication of intramuscular and intraarticular injection of various drugs. "