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Copyright ©The Author(s) 2015.
World J Dermatol. May 2, 2015; 4(2): 103-107
Published online May 2, 2015. doi: 10.5314/wjd.v4.i2.103
Table 1 Clinical features and three phase treatment of nicolau syndrome
PhaseClinical featuresTreatment
InitialIntense painAnalgesics
ErythemaSystemic antibiotics1
Radiating painNo ice pack
Faintness, syncope
AcuteLivedoid plaqueSystemic steroid
Violaceous patchAnticoagulant agent
Non-necrotic
NecroticNecrotic indurated plaqueSurgical debridement
Ulceration with necrosisPlastic surgery
Table 2 Drug list related to nicolau syndrome
DrugTarget disease or symptom of using drugRef.Duration of necrosisAffected site
NaltrexoneAlcohol dependencyPerli et al[25]Over 7 dButtock
EtanerceptPsoriatic arthritisGuarneri et al[21]10 dAbdomen
KetorolacNSMarangi et al[26]2 wkButtock
KetoprofenKnee painKim et al[27]NSButtock
COMLee et al[28]
MeperidineOperation site painKim et al[27]Buttock
GentamycinElbow sprainKim et al[29]Buttock
Chlorpheniramine maleatePruritusNischal et al[30]7 dArm
TrabitBack painRuffieux et al[31]Buttock
Triamcinolone acetonideLichen planus of scalpRuffieux et al[31]Buttock
Salicylate bismuthSyphilisCorazza et al[2]A few daysButtock, thigh
IbuprofenCoxarthrosisCorazza et al[2]Buttock
Interferon βOzcan et al[5]3 dArm
Benzathine penicillinCellulitisRuffieux et al[31]Buttock, L/Ext.
NSDe Sousa et al[32]1 d
Ocak et al[23]
Penicillin GFever and coughLuton et al[12]2 dButtock, L/Ext.
CyanocobalaminLuton et al[12]Buttock
ThiocolchicosideBack painGuarneri et al[7]2Buttock
Glatiramer acetateMultiple sclerosisHarde et al[22]2 dLower abdomen
Koller et al[33]
PiroxicamAnkle sprainLee et al[8]Ankle
DPTVaccinationErkek et al[15]2 wkThigh
DTP-polio-HibVaccinationBégin et al[14]2 wkThigh
HydroxyzineItchingGayken et al[16]Thigh
Calcium hydroxideBleeding in the distal root canalWillbrand et al[34]Cheek
LidocaineCore needle biopsy on breastGarcía-Vilanova-Comas et al[20]Breast
Vitamin KPrematurityPuvabanditsin et al[18]2 wkThigh
Mesotherapy injectionsTendinopathyZaragoza et al[35]3 wkKnee