Demircan Caner, Akdogan Neslihan, Elmas Leyla
Hacettepe University, Ankara, Turkey.
Int J Low Extrem Wounds. 2023 Mar;22(1):149-151. doi: 10.1177/1534734620973144. Epub 2020 Dec 1.
Nicolau syndrome, also known as embolia cutis medicamentosa, is a rare complication of injectable drugs. Patients present with pain at injection site, followed by swelling, erythema, purple, hemorrhagic patches and lastly ulcer formation. A variety of intramuscular agents have been implicated as responsible. 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. The patient was followed up with topical mupirocin. On follow-up, although the patient stated that she continued using glatiramer acetate, no new lesions appeared and the existing lesion continued to shrink. Nicolau syndrome seems to have an unpredictable and unavoidable course. 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.
尼科劳综合征，又称药物性皮肤栓塞，是注射用药物的一种罕见并发症。患者在注射部位出现疼痛，随后出现肿胀、红斑、紫色、出血性斑块，最后形成溃疡。多种肌肉注射药物被认为与此有关。我们报告一例26岁女性，其大腿有紫色病变史，因皮下注射醋酸格拉替雷而被诊断为尼科劳综合征。该患者接受了莫匹罗星局部治疗。随访时，尽管患者表示她继续使用醋酸格拉替雷，但未出现新的病变，现有病变继续缩小。尼科劳综合征似乎有不可预测和不可避免的病程。该病例表明，对于有注射用药物使用史且出现坏死或溃疡性病变的患者，医生应高度怀疑尼科劳综合征的存在。
