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Brief ReportBrief Report

Levamisole-Adulterated Cocaine: A Case Series

Gerald W. Morris, Bryan C. Mason, Rachael Harris Sprunger, Holly Hake Harris, Luke A. White and Dale A. Patterson
The Journal of the American Board of Family Medicine July 2012, 25 (4) 531-535; DOI: https://doi.org/10.3122/jabfm.2012.04.110287
Gerald W. Morris Jr
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Bryan C. Mason
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Rachael Harris Sprunger
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Holly Hake Harris
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Luke A. White
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Dale A. Patterson
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    Figure 1.

    Tender retiform purpuric papules and plaques on left ear (A) and leg (B) that developed after using cocaine suspected of being adulterated with levamisole.

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    Figure 2.

    Punch biopsies taken from case 1 demonstrated fibrin thrombi located in the deep and superficial blood vessels.

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    Figure 3.

    Painful branching livedoid plaques with well demarcated borders on legs (A) and retiform purpuric coalescing plaques on left ear (B). These lesions developed days after using cocaine suspected of being adulterated with levamisole.

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    Figure 4.

    Full-thickness dermal necrosis with sloughing in a wound that was formerly defined by a purpuric plaque (A). After receiving skin grafts, the patient returned 2 months later with necrotic skin lesions encroaching on the previously grafted sites after reusing cocaine (B).

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The Journal of the American Board of Family     Medicine: 25 (4)
The Journal of the American Board of Family Medicine
Vol. 25, Issue 4
July-August 2012
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Levamisole-Adulterated Cocaine: A Case Series
Gerald W. Morris, Bryan C. Mason, Rachael Harris Sprunger, Holly Hake Harris, Luke A. White, Dale A. Patterson
The Journal of the American Board of Family Medicine Jul 2012, 25 (4) 531-535; DOI: 10.3122/jabfm.2012.04.110287

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Levamisole-Adulterated Cocaine: A Case Series
Gerald W. Morris, Bryan C. Mason, Rachael Harris Sprunger, Holly Hake Harris, Luke A. White, Dale A. Patterson
The Journal of the American Board of Family Medicine Jul 2012, 25 (4) 531-535; DOI: 10.3122/jabfm.2012.04.110287
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