Levamisole-induced occlusive necrotising vasculitis in cocaine abusers: an unusual cause of skin necrosis and neutropenia.
We present three cases describing the various skin manifestations of presumed levamisole-contaminated cocaine use. Antibody-mediated vasculitis and neutropenia were consistent findings in these cases and repeat exposure resulted in distinct dermatologic complications. This phenomenon of levamisole-induced vasculitis and neutropenia is being increasingly described and has characteristic wound manifestations that must be recognised and treated early.
Division of Cardiology, Howard University Hospital, Washington, DC, USA Division of Rheumatology, Immunology and Allergy, Georgetown University Hospital, Washington, DC, USA Division of Rheumatology, Veterans Affairs Hospital, Washington, DC, USA Department of Internal Medicine, Howard University Hospital, Washington, DC, USA.
Cassius D
CD
Belfonte
Victoria K
VK
Shanmugam
Nicole
N
Kieffer
Shodeinde
S
Coker
Suelyn
S
Boucree
Gail
G
Kerr
D000276:Adjuvants, Immunologic / Q000009:adverse effects*; D000328:Adult; D003042:Cocaine / Q000009:adverse effects*; D019970:Cocaine-Related Disorders / Q000209:etiology*; D004340:Drug Contamination; D005260:Female; D006801:Humans; D007978:Levamisole / Q000009:adverse effects*; D008875:Middle Aged; D009336:Necrosis / Q000139:chemically induced / Q000150:complications / Q000473:pathology; D009503:Neutropenia / Q000139:chemically induced* / Q000150:complications; D012867:Skin / Q000473:pathology*; D014657:Vasculitis / Q000139:chemically induced* / Q000150:complications / Q000473:pathology
D000276:Adjuvants, Immunologic; D007978:Levamisole; D003042:Cocaine