Skin Necrosis After Ketorolac Intravascular Adminisration

  • Sara Abolghasemi
  • Shahnaz Sali
  • Manijeh Roohi
  • Narjes Shokatpour
Keywords: Intravascular;, Skin necrosis;, Injection;, Non-seroidal anti-inflammatory drugs

Abstract

Skin necrosis is considered as a rare but severe complication of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) injections. Symptoms comprise intense pain around the injection site, evolving into erythema, livedoid violaceous patch, hemorrhagic patch, and eventually necrosis of the skin. The pathogenesis is not fully clear. However, it is presumed that damage to an end artery and the cytotoxic effects of the drug are main causes. We present a patient who developed skin necrosis after ketorolac intravascular adminisration for the treatment of renal colic. To the bes of our knowledge, this is the frs report describing skin necrosis after ketorolac intravascular injection.

References

McGee A, Davison P. Skin necrosis following injection of non‐steroidal anti‐inflammatory drug. British journal of anaesthesia. 2002;88(1):139-40.

https://academic.oup.com/bja/article/88/1/139/259119

Spickler W. Ketorolac (Toradol): a new analgesic or an old NSAID? CMAJ: Canadian Medical Association Journal. 1993;148(10):1693.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1485584/

Kim S-K, Kim T-H, Lee K-C. Nicolau syndrome after intramuscular injection: 3 cases. Archives of plastic surgery. 2012;39(3):249.

https://www.ncbi.nlm.nih.gov/pubmed/22783535

Ozlu E, Baykan A, Ertas R, Ulas Y, Ozyurt K, Avcı A, et al. Case Report: Nicolau syndrome due to etofenamate injection. F1000Research. 2017;6.

https://www.ncbi.nlm.nih.gov/pubmed/28868137

Kosaraju N, Korrapati V, Thomas A, James B. Adult purpura fulminans associated with non-steroidal anti-inflammatory drug use. Journal of postgraduate medicine. 2011;57(2):145.

https://www.ncbi.nlm.nih.gov/pubmed/21654144

Bégin P, Anne DR. Nicolau syndrome may be caused by intravascular vaccine injection. Vaccine. 2012;30(11):2035.

https://www.ncbi.nlm.nih.gov/pubmed/22198515

Dadaci M, Altuntas Z, Ince B, Bilgen F, Tufekci O, Poyraz N. Nicolau syndrome after intramuscular injection of non-steroidal anti-inflammatory drugs (NSAID). Bosnian journal of basic medical sciences. 2015;15(1):57.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4365678/

Marangi GF, Gigliofiorito P, Toto V, Langella M, Pallara T, Persichetti P. Three cases of embolia cutis medicamentosa (Nicolau’s syndrome). The Journal of dermatology. 2010;37(5):488-92.

https://www.ncbi.nlm.nih.gov/pubmed/20536657

Published
2019-01-15
How to Cite
1.
Abolghasemi S, Sali S, Roohi M, Shokatpour N. Skin Necrosis After Ketorolac Intravascular Adminisration. CRCP. 3(3):87-0.
Section
Case Report(s)