TY - JOUR
T1 - Nicolau syndrome caused by non-steroidal anti-inflammatory drugs
T2 - Systematic literature review
AU - Lardelli, Pietro F.
AU - Jermini, Luca M.M.
AU - Milani, Gregorio P.
AU - Peeters, Gabriella G.A.M.
AU - Ramelli, Gian P.
AU - Zgraggen, Lorenzo
AU - Terrani, Isabella
AU - Bianchetti, Mario G.
AU - Vanoni, Federica
AU - Faré, Pietro B.
AU - Lava, Sebastiano A.G.
PY - 2020
Y1 - 2020
N2 - Aim: 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. Methods: The National Library, Excerpta Medica, Web of Science and Cochrane library databases were used. Results: 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). Conclusion: 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.
AB - Aim: 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. Methods: The National Library, Excerpta Medica, Web of Science and Cochrane library databases were used. Results: 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). Conclusion: 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.
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U2 - 10.1111/ijcp.13567
DO - 10.1111/ijcp.13567
M3 - Review article
C2 - 32479658
AN - SCOPUS:85087215866
VL - 74
JO - Medicine illustrated
JF - Medicine illustrated
SN - 1368-5031
IS - 10
M1 - e13567
ER -