[Circumscribed skin necrosis following intramuscular injection (embolia cutis medicamentosa)]

Among the local complications following the intramuscular injection of therapeutic drugs, the syndrome of 'embolia cutis medicamentosa' deserves special attention. Shortly after the intramuscular injection, the patients notice severe pain and an erythematous discoloration of the skin at the injection site, followed by central demarcation and a sharply circumscribed skin necrosis with or without damage to peripheral nerves. We report about three patients, two of which had to be hospitalized. The drugs injected were combinations of analgesics of the phenylbutazone-type, corticosteroids, local anesthetics and cyanocobalamin. The observation that this severe complication may be associated with technically proper ventrogluteal injection of a wide array of therapeutic drugs shows that intramuscular injections require valid indications.