Pediatric Institute of Southern Switzerland, Ospedale San Giovanni, Bellinzona, Switzerland.
Università della Svizzera Italiana, Lugano, Switzerland.
Int J Clin Pract. 2020 Oct;74(10):e13567. doi: 10.1111/ijcp.13567. Epub 2020 Jun 28.
Intramuscular or, more rarely, local drug injection is occasionally followed by immediate local pain, livedoid skin lesions and, some days later, the development of ischemic lesions. This very uncommon but potentially severe reaction, termed Nicolau syndrome, is traditionally associated with bismuth and β-lactam antimicrobials. The aim of this report was to review the literature associating Nicolau syndrome with the administration of non-steroidal anti-inflammatory drugs.
The National Library, Excerpta Medica, Web of Science and Cochrane library databases were used.
Sixty-two cases (40 females and 22 males aged from 13 to 81, median 57 years) of Nicolau syndrome were published after 1992. Fifty-three cases occurred after diclofenac. The remaining nine cases were associated with ketoprofen (N = 2), ketorolac (N = 2), phenylbutazone (N = 2), etofenamate (N = 1), ibuprofen (N = 1) and piroxicam (N = 1).
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.
肌肉内或局部药物注射偶尔会立即引起局部疼痛、类丹毒样皮损，数天后发生缺血性皮损。这种非常罕见但潜在严重的反应，称为尼科劳综合征，传统上与铋剂和β-内酰胺类抗菌药物有关。本报告的目的是回顾文献中与非甾体抗炎药给药相关的尼科劳综合征。
使用国家图书馆、荷兰医学文摘、科学网和考科蓝图书馆数据库。
1992 年后发表了 62 例尼科劳综合征（40 名女性和 22 名男性，年龄 13-81 岁，中位数 57 岁）。53 例发生在双氯芬酸之后。其余 9 例与酮咯酸（N=2）、酮基布洛芬（N=2）、苯丁唑酮（N=2）、依托芬那酯（N=1）、布洛芬（N=1）和吡罗昔康（N=1）有关。
尽管尼科劳综合征极为罕见，但医生必须在肌肉内给予非甾体抗炎药后注意到这种并发症，并应避免不必要的注射。
