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Cutaneous Necrotizing Vasculitis and Leukopenia in a Cocaine User: Is Levamisole the Culprit?

Levamisole is an antihelminthic drug banned by the US Food and Drug Administration (FDA) in 2000 because of its dangerous side effects. Over the past few years, it has been identified as an adulterant in cocaine and reported to cause cutaneous vasculitis in cocaine users. The health burden of levami...

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Detalles Bibliográficos
Autores principales: El Khoury, Lara, Zeineddine, Nabil, Felix, Richard, Goldstein, Mark
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4992510/
https://www.ncbi.nlm.nih.gov/pubmed/27579207
http://dx.doi.org/10.1155/2016/2685267
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author El Khoury, Lara
Zeineddine, Nabil
Felix, Richard
Goldstein, Mark
author_facet El Khoury, Lara
Zeineddine, Nabil
Felix, Richard
Goldstein, Mark
author_sort El Khoury, Lara
collection PubMed
description Levamisole is an antihelminthic drug banned by the US Food and Drug Administration (FDA) in 2000 because of its dangerous side effects. Over the past few years, it has been identified as an adulterant in cocaine and reported to cause cutaneous vasculitis in cocaine users. The health burden of levamisole is serious since it is estimated that over 5 million Americans use cocaine and that 70% of the cocaine used in the USA contains levamisole. In this paper we report the case of a 23-year-old female cocaine user that presented with purpuric rash and skin necrosis, found to have positive c-ANCA and anti-proteinase 3 antibodies. Her skin biopsy showed fibroconnective tissue with signs of necrosis, acute and chronic inflammation, and thrombus formation. She was diagnosed with levamisole-induced vasculitis and successfully treated with withdrawal of cocaine use and local wound care.
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spelling pubmed-49925102016-08-30 Cutaneous Necrotizing Vasculitis and Leukopenia in a Cocaine User: Is Levamisole the Culprit? El Khoury, Lara Zeineddine, Nabil Felix, Richard Goldstein, Mark Case Rep Rheumatol Case Report Levamisole is an antihelminthic drug banned by the US Food and Drug Administration (FDA) in 2000 because of its dangerous side effects. Over the past few years, it has been identified as an adulterant in cocaine and reported to cause cutaneous vasculitis in cocaine users. The health burden of levamisole is serious since it is estimated that over 5 million Americans use cocaine and that 70% of the cocaine used in the USA contains levamisole. In this paper we report the case of a 23-year-old female cocaine user that presented with purpuric rash and skin necrosis, found to have positive c-ANCA and anti-proteinase 3 antibodies. Her skin biopsy showed fibroconnective tissue with signs of necrosis, acute and chronic inflammation, and thrombus formation. She was diagnosed with levamisole-induced vasculitis and successfully treated with withdrawal of cocaine use and local wound care. Hindawi Publishing Corporation 2016 2016-08-07 /pmc/articles/PMC4992510/ /pubmed/27579207 http://dx.doi.org/10.1155/2016/2685267 Text en Copyright © 2016 Lara El Khoury et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
El Khoury, Lara
Zeineddine, Nabil
Felix, Richard
Goldstein, Mark
Cutaneous Necrotizing Vasculitis and Leukopenia in a Cocaine User: Is Levamisole the Culprit?
title Cutaneous Necrotizing Vasculitis and Leukopenia in a Cocaine User: Is Levamisole the Culprit?
title_full Cutaneous Necrotizing Vasculitis and Leukopenia in a Cocaine User: Is Levamisole the Culprit?
title_fullStr Cutaneous Necrotizing Vasculitis and Leukopenia in a Cocaine User: Is Levamisole the Culprit?
title_full_unstemmed Cutaneous Necrotizing Vasculitis and Leukopenia in a Cocaine User: Is Levamisole the Culprit?
title_short Cutaneous Necrotizing Vasculitis and Leukopenia in a Cocaine User: Is Levamisole the Culprit?
title_sort cutaneous necrotizing vasculitis and leukopenia in a cocaine user: is levamisole the culprit?
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4992510/
https://www.ncbi.nlm.nih.gov/pubmed/27579207
http://dx.doi.org/10.1155/2016/2685267
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