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Cutaneous vasculopathy associated with cocaine use.

Nataliya Milman1, C Douglas Smith

  • 1The Arthritis Centre, Ottawa Hospital, and University of Ottawa, 1967 Riverside Drive, Ottawa, Ontario, Canada. nmilman@ottawahospital.on.ca

Arthritis Care & Research
|April 28, 2011
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Summary

Cocaine use can lead to skin issues like ulcers and necrosis, often accompanied by arthritis and positive ANCA tests. Discontinuing cocaine may improve skin symptoms, but continued use can be fatal.

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Area of Science:

  • Rheumatology
  • Dermatology
  • Toxicology

Background:

  • Cocaine use is linked to thrombotic events and rheumatologic conditions.
  • Cutaneous vasculopathy is a notable manifestation of cocaine use.

Purpose of the Study:

  • To describe the clinical features and laboratory findings in patients with cocaine-related cutaneous vasculopathy.

Main Methods:

  • Retrospective case series of 8 patients diagnosed with cocaine-related cutaneous vasculopathy.

Main Results:

  • Patients presented with purpuric lesions, ulcers, and skin necrosis.
  • Common extracutaneous features included fatigue and arthritis.
  • Laboratory findings revealed elevated inflammatory markers, positive perinuclear antineutrophil cytoplasmic antibodies (ANCAs) in all patients, and other autoantibodies.
  • Skin disease improved in some patients who ceased cocaine use, while it was progressive in those who continued.

Conclusions:

  • Cocaine-related cutaneous vasculopathy presents with distinct clinical and laboratory features.
  • These findings, in the appropriate clinical context, should raise suspicion for cocaine-induced vasculopathy.