[Nicolau livedoid dermatitis after sclerotherapy of varicose veins].

Abstract

BACKGROUND:

The accidental intra arterial injection of a sclerosing drug is a rare but well known accident, which can cause ischemia of the limb. The aspect of Nicolau livedoid dermatitis is less acknowledged. The ignorance of this entity or the confusion between the latter and an extravasation of the injected drug can delay an urgent treatment.

CASE REPORT:

A 39 year-old woman went to outpatients consultation, after sclerotherapy of a varicose vein of the right popliteal area, for the occurrence of a purpuric, painful plaque of the right popliteal area and the right calf. In spite of the late institution of a treatment including a potent vasodilator (iloprost) and an anticoagulant (calcic nadroparin), the patient recovered without important after effects.

DISCUSSION:

Nicolau livedoid dermatitis during sclerotherapy of a varicose vein has rarely been described before. Our case emphasizes the fact that these apparently superficial injections might involve this complication. Using an echo-Doppler device for targeting the varicose vein did not prevent the accident. Successive punctures on one site before injection might favor this event. Prevention relies on guidelines for the injection technique. Respecting these guidelines reduces the risk of complication without completely preventing it.

• Authors: J-P Trinh-Khac, A Roux, A Djandji, S Aractingi
• Journal: Annales de dermatologie et de venereologie (Ann Dermatol Venereol) Vol. 131 Issue 5 Pg. 481-5 (May 2004) ISSN: 0151-9638 [Print] France
• Vernacular Title: Dermite livedoïde de Nicolau après sclérothérapie de varices.
• PMID: 15235539 (Publication Type: Case Reports, English Abstract, Journal Article)

Topics

• Adult
• Female
• Humans
• Leg
• Sclerotherapy (adverse effects)
• Skin Diseases, Vascular (etiology)
• Varicose Veins (therapy)