Department of Dermatology and Venereology, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey.
Department of Pathology, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey.
Indian J Pharmacol. 2021 Nov-Dec;53(6):489-492. doi: 10.4103/ijp.ijp_166_21.
Nicolau syndrome is a rare serious drug reaction associated with the administering various injectable medications. It is often characterized by an acute and severe pain accompanying erythema that tends to rapidly evolve into the livedoid reticular or hemorrhagic patches and less commonly to ulcers and skin necrosis. Herein, we report a 34-year-old woman who presented with painful, tender discoloration over her abdominal skin following subcutaneous glatiramer acetate injection. Since the patient was diagnosed with multiple sclerosis 18 months ago, she had been on treatment with subcutaneous glatiramer acetate injections thrice weekly. The patient was diagnosed with Nicolau syndrome clinically and histopathologically. After 15-day treatment with topical betamethasone valerate and mucopolysaccharide polysulfate cream twice daily, the lesion completely regressed with only minimal hypopigmented irregular scarring. Nicolau syndrome should be considered in patients with severe pain, tenderness, and redness localized at the injection site following glatiramer subacetate.
尼科劳综合征是一种罕见的严重药物反应，与各种注射药物的使用有关。它通常表现为急性和剧烈疼痛，伴有红斑，红斑往往迅速发展为网状或出血性斑块，较少见的是溃疡和皮肤坏死。在此，我们报告一例 34 岁女性，在接受皮下注射醋酸格拉替雷后出现腹部皮肤疼痛、触痛和变色。由于该患者在 18 个月前被诊断为多发性硬化症，她一直接受每周三次的皮下注射醋酸格拉替雷治疗。该患者临床和组织病理学诊断为尼科劳综合征。经过 15 天的外用倍他米松戊酸酯和粘多糖多硫酸酯乳膏，每日两次治疗后，病变完全消退，仅留下轻微的色素减退不规则瘢痕。对于接受格拉替雷治疗后出现严重疼痛、触痛和红斑的患者，应考虑尼科劳综合征。
