| Autor: |
Urosevic-Maiwald M; Hautärzte-Zentrum am Zürisee, 8008 Zurich, Switzerland.; Faculty of Medicine Zurich, University Zurich, 8032 Zurich, Switzerland., Hardenberg JB; Department of Dermatology, University Hospital Zurich, 8091 Zurich, Switzerland.; Department of Nephrology and Intensive Care Medicine, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany., Hafner J; Department of Dermatology, University Hospital Zurich, 8091 Zurich, Switzerland., Brüggen MC; Faculty of Medicine Zurich, University Zurich, 8032 Zurich, Switzerland.; Department of Dermatology, University Hospital Zurich, 8091 Zurich, Switzerland.; Medical Campus Davos, Swiss Institute of Allergy Research (SIAF), 7265 Davos, Switzerland. |
| Abstrakt: |
The use of levamisole as the most frequent adulterant of cocaine has merged in previously unknown toxicities, notably a disease entity called cocaine/levamisole-associated autoimmune syndrome (CLAAS). Clinically, CLAAS can manifest with diverse cutaneous and extracutaneous features sharing common laboratory findings (neutropenia, autoantibody patterns). We report the case of a cocaine-abusing female patient with relapsing episodes of painful ulcers, worsening and expanding over a three-year period. The case exhibited all features of a drug-induced, skin-limited, ANCA-associated vasculitis, evolving over time to PG-like findings. In both disease stages, the patient responded well to the cessation of cocaine exposure and systemic glucocorticosteroids. This case demonstrates the continuous nature of cutaneous CLAAS manifestations in a single patient. CLAAS has become a major public health issue in the at-risk group of cocaine users, and clinicians should be alert of this condition when treating cocaine users presenting with single or multiple skin ulcerations. |
