Successful treatment of nicolau syndrome with platelet rich plasma

Platelet rich plasma (PRP) therapy has been growing in popularity as a viable treatment alternative for a number of clinical applications and has a potential benefit for use in wound healing. The objective of the present study was to verify the effectiveness of PRP in the management of the refractory cutaneous ulcer associated with Nicolau syndrome. A 73-year-old woman with a diclofenac sodium intramuscular injection history in a local clinic presented with a severely painful acute necrotic ulcer on the right buttock. The ulcerative wound showed no improvement despite having conventional treatment for 1 month. After 3 weeks of the PRP treatment, the wound evolved favorably, with the alleviation of severe pain. It showed a size reduction of more than 80% after 4 months of regular follow up. The result demonstrated that PRP treatment could be an appropriate option for an extensive refractory ulceration associated with Nicolau syndrom.