Ann Dermatol.  2015 Feb;27(1):117-119. 10.5021/ad.2015.27.1.117.

Retiform Purpura Caused by the Use of Cocaine, That Was Probably Adulterated with Levamisole

• Torregrosa Calatayud JL
• Garcias Ladaria J
• De Unamuno Bustos B
• Zaragoza Ninet V
• Alegre De Miquel V

• KMID: 2264858
• DOI: http://doi.org/10.5021/ad.2015.27.1.117

Abstract

No abstract available.

MeSH Terms

Cocaine*
Levamisole*
Purpura*
Cocaine
Levamisole

Figure

• 

  Fig. 1 (A) A reticular plaque with purpuric edges and necrotic center on the left cheek. (B) Reticular and stellate plaques with purpuric edges and necrotic center on low limbs.

• 

  Fig. 2 Hematoxylin-eosin staining image (×10) showing thrombotic vasculopathy of the small and medium blood vessels in the dermis and subcutaneous cell tissue.

Reference

1. Lee KC, Ladizinski B, Federman DG. Complications associated with use of levamisole-contaminated cocaine: an emerging public health challenge. Mayo Clin Proc. 2012; 87:581–586.

2. Ventura Vilamala M, Caudevilla Gálligo F, Vidal Giné C. Grupo Investigadores SELECTO. Levamisole-adulterated cocaine: potential clinical implications. Med Clin (Barc). 2011; 136:367–368.

3. Rongioletti F, Ghio L, Ginevri F, Bleidl D, Rinaldi S, Edefonti A, et al. Purpura of the ears: a distinctive vasculopathy with circulating autoantibodies complicating long-term treatment with levamisole in children. Br J Dermatol. 1999; 140:948–951.

4. Lynch KL, Dominy SS, Graf J, Kral AH. Detection of levamisole exposure in cocaine users by liquid chromatography-tandem mass spectrometry. J Anal Toxicol. 2011; 35:176–178.

5. de la Hera I, Sanz V, Cullen D, Chico R, Petiti G, Villar M, et al. Necrosis of ears after use of cocaine probably adulterated with levamisole. Dermatology. 2011; 223:25–28.