Senel Engin, Ada Simin, Güleç Ayşe Tülin, Cağlar Bariş
Department of Dermatology, Başkent University Faculty of Medicine, Ankara, Turkey.
J Dermatol. 2008 Jan;35(1):18-20. doi: 10.1111/j.1346-8138.2007.00404.x.
Nicolau syndrome is a rare but well-recognized cutaneous adverse drug reaction at the site of i.m. injection of certain drugs. Clinically, it is characterized by severe pain immediately after the injection followed by an erythematous reticular patch that may result in a necrotic ulcer and scarring at the injection site. We describe a 60-year-old woman with a painful, violaceous, crusted plaque after i.m. diclofenac administration to her right buttock. She had applied an ice pack to this area immediately after the injection to relieve the pain without any benefit. A clinical diagnosis of Nicolau syndrome due to diclofenac injection was made, and reconstructive surgery of the wound was performed. Although diclofenac is a widely used non-steroidal anti-inflammatory drug, Nicolau syndrome following i.m. diclofenac injection has rarely been reported in the published work. Application of a cold compress was considered an aggravating factor in our patient.
尼科劳综合征是一种罕见但已被充分认识的在肌肉注射某些药物部位发生的皮肤药物不良反应。临床上，其特征为注射后立即出现严重疼痛，随后出现红斑网状斑块，这可能导致注射部位坏死性溃疡和瘢痕形成。我们描述了一名60岁女性，在右臀部肌肉注射双氯芬酸后出现疼痛性、紫红色、结痂斑块。注射后她立即在该区域使用冰袋以缓解疼痛，但没有任何效果。做出了因双氯芬酸注射导致尼科劳综合征的临床诊断，并对伤口进行了重建手术。尽管双氯芬酸是一种广泛使用的非甾体抗炎药，但在已发表的文献中，肌肉注射双氯芬酸后发生尼科劳综合征的报道很少。在我们的患者中，冷敷被认为是一个加重因素。
