A 35-year-old man presented with a painful skin necrosis after a deep ventrogluteal injection of diclofenac and dexamethasone for treatment of severe back pain. Immediately after the injection, the patient felt a strong pain just above the injection site. In the following days a remarkable necrosis developed in the upper gluteal region. Topical therapy with antiseptics and a topical corticosteroid cream plus analgesia with tramadole revealed no improvement of the symptoms. We excised the necrotic area. Within 1 day, the patient was without pain.