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Nicolau syndrome (NS) also known as livedo-like dermatitis, is an uncommon but important cutaneous drug reaction. It was first described in 1924 and since then many patients have been reported in the literature. The disorder is characterized by intense pain in the injection site and followed by a livedoid reticular patch or indurated plaque. In some patients, this condition may progress into extensive necrosis of the skin and ulceration as seen in our patient. Herein we presented a 52-year-old man and presented with a painful, large ulcer on his left buttock after intramuscular diclofenac sodium administration and diagnosed with NS to draw attention of physicians to this rare and preventable condition. [ABSTRACT FROM AUTHOR]