title: Levamisole-adulterated cocaine: a case series.
abstract: The percentage of cocaine adulterated with levamisole is steadily increasing in the United States. In susceptible persons, this combination of drugs leads to a clinical syndrome that can include leukopenia and cutaneous manifestations. Many patients also demonstrate positive autoimmune markers. Biopsies of skin lesions often reveal a thrombotic pattern, leukocytoclastic vasculitis, or both. We report 2 cases of this clinical phenomenon, one of which was severe enough to require skin grafting. It is important for clinicians be aware of this emerging public health threat.
authors: Memorial Family Medicine Residency, Memorial Hospital, South Bend, IN, USA.
authors: Gerald W
authors: GW
authors: Morris
authors: Bryan C
authors: BC
authors: Mason
authors: Rachael
authors: R
authors: Harris Sprunger
authors: Holly
authors: H
authors: Hake Harris
authors: Luke A
authors: LA
authors: White
authors: Dale A
authors: DA
authors: Patterson
mesh_terms: D001706:Biopsy; D019970:Cocaine-Related Disorders / Q000175:diagnosis* / Q000473:pathology*; D004340:Drug Contamination; D005260:Female; D006801:Humans; D007970:Leukopenia / Q000139:chemically induced; D007978:Levamisole / Q000009:adverse effects*; D008875:Middle Aged; D012867:Skin / Q000473:pathology; D014481:United States; D055815:Young Adult
chemical_list: D007978:Levamisole