Nicolau Syndrome

Nicolau Syndrome, also known as embolia cutis medicomentosa and livedo-like dermatitis, is a rare cutaneous adverse reaction at the site of intramuscular, intra-articular, subcutaneous injection of particular drugs. Patients complain of severe pain and erythematous-ecchymotic reticular lesions at the injection site. The skin, subcutaneous and muscle tissue necrosis develop as complications of injections.

Our case was a 68 year-old female patient followed with chronic liver disease who developed necrosis of the skin in the right hip after intramuscular diclofenac injection.

Although diclofenac is a widely used non-steroidal anti-inflammatory drug, Nicolau syndrome following intramuscular diclofenac injection has rarely been reported. And also, in our literature examination it is the first case of Nicolau Syndrome with chronic liver dissease.