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Buprenorphine Induced Nicolau Syndrome: A Case Report

Buprenorphine Induced Nicolau Syndrome: A Case Report Letter to the Editor Buprenorphine Induced FIGURE 1. Presence of Non-blanchable Purpuric Macules and Patches in a Nicolau Syndrome: Retiform Pattern over the Sole of the Right Foot. A Case Report Dear Editor, icolau syndrome is a rare ad- verse effect due to inadvertent Narterial injection by a number of drugs leading to painful ulcerative skin lesions. It has been reported commonly with non-steroidal anti-inflammatory drugs (NSAIDs) and antibiotics; howev- er, buprenorphine has been rarely im- plicated in its causation. We present an intriguing case of Nicolau syndrome fol- lowing self-injection of buprenorphine. A 24-year-old male, an intravenous drug abuser, presented with a painful erythema- tous rash over his right lower limb for five days. The patient had self-injected a sus- pension of buprenorphine (tablet crushed in drinking water) into the upper lateral aspect of his right leg five days back. The lesions started from the foot and gradually progressed to involve the lateral aspect of the leg over two to three days. There was no history of any sensory disturbances or any restriction of movement. He gave a history of self-administration of heroin injections over multiple sites in the past. On examination, the presence of tender, non-blanchable purpuric http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Indian Journal of Psychological Medicine SAGE

Buprenorphine Induced Nicolau Syndrome: A Case Report

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References (9)

Publisher
SAGE
Copyright
© 2023 The Author(s)
ISSN
0253-7176
eISSN
0975-1564
DOI
10.1177/02537176241296307
Publisher site
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Abstract

Letter to the Editor Buprenorphine Induced FIGURE 1. Presence of Non-blanchable Purpuric Macules and Patches in a Nicolau Syndrome: Retiform Pattern over the Sole of the Right Foot. A Case Report Dear Editor, icolau syndrome is a rare ad- verse effect due to inadvertent Narterial injection by a number of drugs leading to painful ulcerative skin lesions. It has been reported commonly with non-steroidal anti-inflammatory drugs (NSAIDs) and antibiotics; howev- er, buprenorphine has been rarely im- plicated in its causation. We present an intriguing case of Nicolau syndrome fol- lowing self-injection of buprenorphine. A 24-year-old male, an intravenous drug abuser, presented with a painful erythema- tous rash over his right lower limb for five days. The patient had self-injected a sus- pension of buprenorphine (tablet crushed in drinking water) into the upper lateral aspect of his right leg five days back. The lesions started from the foot and gradually progressed to involve the lateral aspect of the leg over two to three days. There was no history of any sensory disturbances or any restriction of movement. He gave a history of self-administration of heroin injections over multiple sites in the past. On examination, the presence of tender, non-blanchable purpuric

Journal

Indian Journal of Psychological Medicine – SAGE

Published: Jan 1, 2024

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