Levamisole-adulterated cocaine: a case series

J Am Board Fam Med. 2012 Jul-Aug;25(4):531-5. doi: 10.3122/jabfm.2012.04.110287.

Abstract

The percentage of cocaine adulterated with levamisole is steadily increasing in the United States. In susceptible persons, this combination of drugs leads to a clinical syndrome that can include leukopenia and cutaneous manifestations. Many patients also demonstrate positive autoimmune markers. Biopsies of skin lesions often reveal a thrombotic pattern, leukocytoclastic vasculitis, or both. We report 2 cases of this clinical phenomenon, one of which was severe enough to require skin grafting. It is important for clinicians be aware of this emerging public health threat.

Publication types

  • Case Reports

MeSH terms

  • Biopsy
  • Cocaine-Related Disorders / diagnosis*
  • Cocaine-Related Disorders / pathology*
  • Drug Contamination*
  • Female
  • Humans
  • Leukopenia / chemically induced
  • Levamisole / adverse effects*
  • Middle Aged
  • Skin / pathology
  • United States
  • Young Adult

Substances

  • Levamisole