Open AccessNicolau syndrome caused by non‐steroidal anti‐inflammatory drugs: Systematic literature review
Author(s) -
Lardelli Pietro F.,
Jermini Luca M. M.,
Milani Gregorio P.,
Peeters Gabriella G. A. M.,
Ramelli Gian P.,
Zgraggen Lorenzo,
Terrani Isabella,
Bianchetti Mario G.,
Vai Federica,
Faré Pietro B.,
Lava Sebastiano A. G.
Publication year - 2020
Publication title -
international journal of clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.756
H-Index - 98
eISSN - 1742-1241
pISSN - 1368-5031
DOI - 10.1111/ijcp.13567
Subject(s) - medicine , diclofenac , ketorolac , piroxicam , ketoprofen , ibuprofen , phenylbutazone , complication , surgery , dermatology , anesthesia , analgesic , pharmacology , alternative medicine , pathology
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.