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Related Experiment Video

Updated: May 8, 2026

High-Resolution Three-Dimensional Imaging of the Footpad Vasculature in a Murine Hindlimb Gangrene Model

High-Resolution Three-Dimensional Imaging of the Footpad Vasculature in a Murine Hindlimb Gangrene Model

Published on: March 16, 2022

Cocaine-induced leg ulceration.

Khaled Shawwa¹, Abdul Hamid Alraiyes, Naseem Eisa

¹American University of Beirut Medical Center, Beirut, Lebanon.

BMJ Case Reports

|September 3, 2013

Summary

Levamisole, a cocaine adulterant, caused severe skin ulcers and neutropenia in a patient. Recurrence of cocaine use led to worsening symptoms, highlighting the dangers of adulterated drugs.

Area of Science:

Dermatology
Toxicology
Internal Medicine

Background:

Cocaine adulteration with levamisole is a growing public health concern.
Levamisole is associated with various adverse effects, including skin manifestations and hematological abnormalities.

Observation:

A 48-year-old woman developed bilateral leg rash, fever, and cough after snorting cocaine.
Physical exam revealed violaceous plaques and bullae; lab work showed neutropenia.
Skin biopsy indicated thrombogenic vasculopathy, consistent with levamisole ingestion.

Findings:

The patient's condition initially improved with abstinence and supportive care.
Readmission occurred due to recurrent cocaine use, leading to new lesions and necrotic ulcer exacerbation.
Positive antinuclear antibody, perinuclear antineutrophil cytoplasmic antibody, and anti-double-stranded DNA antibodies were noted.

Related Experiment Videos

Last Updated: May 8, 2026

High-Resolution Three-Dimensional Imaging of the Footpad Vasculature in a Murine Hindlimb Gangrene Model

High-Resolution Three-Dimensional Imaging of the Footpad Vasculature in a Murine Hindlimb Gangrene Model

Published on: March 16, 2022

Implications:

This case underscores the severe dermatological and systemic risks of levamisole-adulterated cocaine.
Patient education and cessation of cocaine use are critical for managing levamisole toxicity.
Prompt recognition and management of levamisole-induced vasculopathy are essential to prevent complications.