Kimbrough Dorlan J, Newsome Scott D
Int J MS Care. 2017 May-Jun;19(3):148-150. doi: 10.7224/1537-2073.2016-038.
We report two cases of Nicolau syndrome (embolia cutis medicamentosa), a rare complication of injectable medications, both associated with the administration of 20 mg of subcutaneous glatiramer acetate. Both patients required surgical debridement and were subsequently treated conservatively without additional complications. Patient 1 opted to discontinue disease-modifying therapy. Patient 2 continued glatiramer acetate therapy without complications by using other injection sites. These cases highlight the need for prompt investigation of new unusual skin lesions in patients receiving injectable multiple sclerosis treatments (regardless of length of treatment and previous minor cosmetic concerns) and illustrate the clinical distinction between Nicolau syndrome and drug-induced skin necrosis.
我们报告了两例尼科劳综合征（药物性皮肤栓塞），这是注射用药的一种罕见并发症，均与皮下注射20毫克醋酸格拉替雷有关。两名患者均需手术清创，随后接受保守治疗，未出现其他并发症。患者1选择停用疾病修饰疗法。患者2通过使用其他注射部位继续接受醋酸格拉替雷治疗，未出现并发症。这些病例凸显了对接受注射用多发性硬化症治疗的患者（无论治疗时长及既往轻微的美容问题）出现的新的异常皮肤损害进行及时调查的必要性，并阐明了尼科劳综合征与药物性皮肤坏死之间的临床区别。
