A Case of Cutaneous Vasculitis in the Setting of Systemic Lupus Erythematosus and Cocaine Use

Autor: Chad M. Jaenke BS, Sara R. Moore PhD, Matthew D. Miller BA, Anu Garg MD
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Journal of Investigative Medicine High Impact Case Reports, Vol 11 (2023)
Druh dokumentu: article
ISSN: 2324-7096
23247096
DOI: 10.1177/23247096231176215
Popis: Cocaine, one of most prevalent illicit substances in the United States, affects a multitude of organ systems and precedes numerous negative health outcomes. Many of the consequences of cocaine are linked to induction of vasoconstriction. For this reason, cocaine users are placed at considerable risk of ischemic stroke, myocardial infarction, and cardiac arrhythmias. Furthermore, a prominent contaminant, levamisole, has been widely implicated in predisposing individuals to developing or exacerbating cutaneous vasculitides. This report details a 31-year-old woman with acute, localized necrotic skin lesions after cocaine use. Her clinical picture was complicated by a 17-year history of systemic lupus erythematosus (SLE) and Raynaud’s phenomenon. This case examines the challenge of forming a differential diagnosis, initiating an appropriate workup, and interpreting serologic-based and immunologic-based studies to differentiate between SLE and drug-based etiologies of skin necrosis. Finally, we discuss appropriate treatment plans to mitigate symptoms and reduce future instances of drug-induced vasculitis.
Databáze: Directory of Open Access Journals