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Recurrent Thrombotic Vasculopathy in a Former Cocaine User
Preeti Jadhav1, Hassan Tariq1, Masooma Niazi2
1Bronx Lebanon Hospital Center, Department of Medicine, 1650 Selwyn Avenue, Suite No. 10C, Bronx, NY 10457, USA.
Case Reports in Dermatological Medicine
|January 22, 2016
Summary
A patient with a history of cocaine use developed a recurrent pruritic rash. Skin biopsy revealed thrombotic vasculopathy, likely caused by levamisole, a common cocaine adulterant.
Area of Science:
- Dermatology
- Toxicology
- Pathology
Background:
- Recurrent pruritic rash in a 35-year-old female with a history of cocaine use.
- Previous diagnosis of cocaine-induced vasculitis in 2013.
- Patient had ceased cocaine use after rehabilitation, confirmed by negative toxicology.
Purpose of the Study:
- To investigate the etiology of a recurrent pruritic rash in a patient with a history of cocaine use.
- To determine the cause of thrombotic vasculopathy in the absence of other identifiable factors.
Main Methods:
- Clinical presentation and patient history review.
- Skin lesion biopsy for histopathological examination.
- Exclusion of autoimmune and infectious causes through comprehensive workup.
Main Results:
- Skin biopsy confirmed thrombotic vasculopathy.
- No other autoimmune or infectious etiology was identified.
- The findings were consistent with levamisole-induced vasculopathy.
Conclusions:
- Levamisole, a frequent adulterant in cocaine, is a likely cause of the patient's recurrent thrombotic vasculopathy and rash.
- This case highlights the importance of considering adulterants in drug-induced conditions.
- Early identification and cessation of exposure are crucial for managing levamisole-induced vasculopathy.