Embolia cutis Medicamentosa (Nicolau syndrome): case series

• Published in: Frontiers in medicine Vol. 10; p. 1216781
• Main Authors: Fekete, Gyula Laszlo, Iantovics, Laszlo Barna, Fekete, Júlia Edit, Fekete, Laszlo
• Format: Report
• Language: English
• Published: 01-01-2023
• ISSN: 2296-858X; 2296-858X
• DOI: 10.3389/fmed.2023.1216781

IntroductionEmbolia cutis medicamentosa or Nicolau syndrome is a rare drug reaction associated with the administration of various injectable medications. The pathogenesis of the disease is unknown, though intra and periarterial injection of the drug is a possible cause. The aim of this study was to describe and analyze the clinical characteristics of Nicolau syndrome in patients examined in daily dermatological practice.MethodsWe performed a retrospective chart review, between January 2011 and December 2020, in patients diagnosed with Nicolau syndrome, from the cases of a private dermatology medical office in Târgu Mureș, Romania.ResultsDuring the 10-year period, 7 patients were diagnosed with Nicolau syndrome. Of these, 4 (57%) patients were males and 3 (43%) were females, The male to female ratio was 1.33. The median age was 64 (interquartile range, IQR, 62-71), with the youngest patient being diagnosed at age 61 and the oldest at age 74. Regarding the drugs classes that caused Nicolau syndrome, these were intravenous antibiotics in 57%, and non-steroidal anti-inflammatory drugs in 43% of cases.ConclusionAll patients healed in a period of 6 to 8 weeks. No complications occurred. In conclusion, Nicolau syndrome is a rare side effect of injectable drug administration.