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Year : 2016  |  Volume : 5  |  Issue : 3  |  Page : 712-715

Cocaine-induced vasculitis with cutaneous manifestation: A recurrent episode after 2 years

1 Department of Internal Medicine, Interfaith Medical Center, Brooklyn, New York, USA
2 Division of Rheumatology, Interfaith Medical Center, Brooklyn, New York, USA
3 Department of Pathology, Interfaith Medical Center, Brooklyn, New York, USA

Correspondence Address:
Thein Swe
400 Herkimer Street, Apt 1K, Brooklyn, New York 11213
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2249-4863.197294

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Cocaine is a popular recreational drug in the United States, and up to 70% of the seized cocaine contains levamisole which is an antihelminthic that can cause cutaneous vasculitis with necrosis and positive antineutrophil cytoplasmic antibodies (ANCAs). Here, we report a unique case of recurrent cocaine-induced vasculitis in a patient who smokes cocaine for more than 20 years. A 38-year-old woman complained of painful erythematous rash in her right arm and right thigh which appeared some hours after smoking cocaine. Physical examination revealed tender, erythematous base, retiform purpura with necrosis and bullae. Serological test showed high atypical perinuclear ANCA titer of 1:320 and antimyeloperoxidase antibody level of 20.4 U/mL. Cocaine-induced vasculitis should be one of the differential diagnoses in cocaine abusers who present with painful rash and areas of necrosis. Early diagnosis is important since it is an emerging public health concern.

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