PMC5670294_01
Fourteen hours after initiation of terlipressin treatment skin purpuric lesions developed on the (A) left arm, (B) lower abdomen and (C, D) breasts
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PMC5670294_01_AnnGastroenterol-30-700-g001.jpg
F1
Two hours after the third 2 mg dose of terlipressin iv (doses given every 4 h), the patient developed purpuric skin lesions on her left arm (Fig. 1A), both breasts (Fig. 1C) and lower abdomen (Fig. 1B, D).
The evolution of skin lesions on the patient's left arm: (A) 24 h following initiation of terlipressin treatment; (B, C, D) 36 h following treatment initiation
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PMC5670294_01_AnnGastroenterol-30-700-g002.jpg
F2
The lesions evolved rapidly (Fig. 2) to necrosis and a cutaneous biopsy performed 48 h after the start of treatment led to the diagnosis of embolia cutis medicamentosa (ECM) or Nicolau syndrome (Fig. 3).