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Vasculitis/Vasculopathy Syndrome Induced by Cocaine–Levamisole

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New and Emerging Entities in Dermatology and Dermatopathology

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Abstract

Levamisole, a pharmacologic agent used for veterinary purposes as an antihelminthic agent, has been identified as an adulterant in cocaine in the United States since 2003. In 2010, the first reports of a distinct syndrome of necrotic facial lesions, retiform purpura, neutropenia, and antineutrophil cytoplasmic antibody positivity emerged secondary to levamisole-adulterated cocaine abuse emerged. Histopathologic examination of skin lesions demonstrates small-vessel vasculitis, with or without intravascular thrombi. Cutaneous lesions remit after discontinuation of cocaine, but recur with rechallenge.

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Authors and Affiliations

  1. The Ohio State University Wexner Medical Center, Columbus, OH, USA

    Catherine G. Chung

  2. University of Rochester Medical Center, Rochester, NY, USA

    Mary Gail Mercurio

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  1. Catherine G. Chung
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Correspondence to Mary Gail Mercurio .

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Editors and Affiliations

  1. Unit of Clinical Dermatology, Vita-Salute S.Raffaele University, Milan, Italy

    Franco Rongioletti

  2. Department of Pathology, University of Rochester, Rochester, NY, USA

    Bruce R. Smoller

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Chung, C.G., Mercurio, M.G. (2021). Vasculitis/Vasculopathy Syndrome Induced by Cocaine–Levamisole. In: Rongioletti, F., Smoller, B.R. (eds) New and Emerging Entities in Dermatology and Dermatopathology. Springer, Cham. https://doi.org/10.1007/978-3-030-80027-7_33

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  • DOI: https://doi.org/10.1007/978-3-030-80027-7_33

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