Nicolau syndrome: a report of 2 cases

Abstract

Nicolau syndrome or embolia cutis medicamentosa is a very rare, but well recognized complication of intramuscular injections which clinically presents with extensive necrosis of the injected skin area. Intra-arterial or para-arterial injection after unintentional perforation of certain vessels could be the possible mechanisms. We describe 2 cases of Nicolau syndrome resulting from intramuscular injection of Diclofenac. Since irreversible tissue damage may occur within a short duration and, as the there is no definitive treatment for this condition, precautionary measures are emphasized.