Embolia Cutis Medicamentosa Following Intramuscular Injection of Diclofenac

Nicolau syndrome or embolia cutis medicamentosa is a rare complication of a still largely unidentified pathogenesis at the site of intramuscular injections of various drugs. It is characterized by development of an acute, severe pain around the injection site followed by a localized erythema, a reticular rash, a hemorrhagic patch and varying degrees of tissue damage. The disease outcomes vary from atrophic ulcers and pigmentation to lower limb paralysis and limb amputation. We describe a 34-year-old woman with the diagnosis of this syndrome after she received an intramuscular diclofenac-beta-dimethyl-aminoethanol injection to the lateral aspect of the right upper buttock. The patient was treated by surgical debridement with concomitant primary closure. (Korean J Dermatol 2010;48(9):786∼789)Key Words: Diclofenac, Nicolau syndrome서 론