Nicolau Syndrome: A Review of the Literature

Nicolau Syndrome, first described in the 1920’s in patients treated with bismuth salts for syphilis, is a rare adverse reaction at the site of intramuscular drug injection. It is clinically characterized by severe pain immediately after injection, and rapid development of blanched skin or livedoid reticular patches. Occlusion of peripheral arterial vessels is suggested to play a major pathogenic role. Since there is no specific therapy for this condition, an appropriate conservative treatment should be applied.