Nicolau syndrome in an athlete following intra-muscular diclofenac injection


Published online: Dec 27 2008

Bruce Hamilton, Peter Fowler, Howard Galloway, Nebojsa Popovic

From Aspetar, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar

Abstract

Nicolau Syndrome (also known as Embolia cutis medicamentosa and livedo-like dermatitis) is a rare but severe localized adverse drug reaction to a range of intra-muscular preparations. It manifests as acute pain, cutaneous, subcutaneous and intra-muscular inflammation and necrosis immediately following an injection, with potentially devastating sequelae. We describe the syndrome in a 21-year-old national level race walk athlete following an intramuscular diclofenac injection.