Abtahi-Naeini Bahareh, Babaie Sharareh, Seyedyousefi Sarah, Ahmadinia Fateme
Pediatric Dermatology Division of Department of Pediatrics, Imam Hossein Children's Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
J Med Case Rep. 2025 Jul 27;19(1):370. doi: 10.1186/s13256-025-05437-2.
Nicolau syndrome is a rare but serious complication that can occur following various forms of drug administration, particularly intramuscular injections. It is characterized by the onset of painful edema in the affected area shortly after the injection, often accompanied by notable livedoid discoloration of the skin, which can lead to ischemic necrosis of the surrounding skin, soft tissue, and muscular tissue.
Here, we report a 4-year-old Iranian girl who developed significant swelling and discoloration in the buttock area, accompanied by severe pain after receiving an intramuscular injection of triamcinolone acetonide for progressive vitiligo. On the basis of the patient's clinical presentation, medical history, and imaging findings, a definitive diagnosis of NS was established. She was managed effectively with prophylactic antibiotics, analgesics, and antithrombotic therapy.
Healthcare providers must be aware of the potential complications associated with intramuscular injections. Recognizing signs of distress, such as significant pain and discoloration, is crucial for timely intervention, which can significantly improve patient outcomes.
尼科劳综合征是一种罕见但严重的并发症，可发生于各种给药方式之后，尤其是肌肉注射后。其特征为注射后不久，受影响区域出现疼痛性水肿，常伴有明显的网状皮肤变色，这可导致周围皮肤、软组织和肌肉组织的缺血性坏死。
在此，我们报告一名4岁的伊朗女孩，她因进行性白癜风接受曲安奈德肌肉注射后，臀部区域出现明显肿胀和变色，并伴有剧痛。根据患者的临床表现、病史和影像学检查结果，确诊为尼科劳综合征。通过预防性使用抗生素、镇痛药和抗血栓治疗，她得到了有效治疗。
医护人员必须意识到肌肉注射相关的潜在并发症。识别如剧痛和变色等痛苦迹象对于及时干预至关重要，这可显著改善患者预后。
