skin necrosis after ketorolac intravascular adminisration

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 administration for the treatment of renal colic. to the best of our knowledge, this is the first report describing skin necrosis after ketorolac intravascular injection.