Heroin-induced thrombocytopenic purpura

An immunologic response to the quinine used to "cut" heroin caused oral manifestations of thrombocytopenic purpura. The patient had an admission platelet count of 2,000 per cubic millimeter. Treatment with corticosteroids and withholding of the offending resulted in a platelet count of 265,000 per cubic millimeter 13 days after admission. Oral manifestations of purpura disappeared on the fourth day of treatment.