Navigation Links
Contaminated cocaine triggers decaying, dying skin

If the obvious reasons for avoiding recreational drug use aren't off-putting enough, physicians have yet another detrimental consequence to add to the list crusty, purplish areas of dead skin that are extremely painful and can open the door to nasty infections.

The condition is called purpura. Typical causes include a range of rare disorders, but it is also associated with the use of cocaine. Not just any cocaine, though: Physicians, researchers and health officials believe cocaine contaminated with a de-worming drug commonly used by veterinarians is the culprit. The drug, called levamisole, was found in 30 percent of confiscated cocaine in 2008 and 70 percent in 2009, according to the U.S. Drug Enforcement Administration.

In the Journal of the American Academy of Dermatology, physicians highlight six new and very similar patient cases of purpura, mostly on and around the ears, following cocaine use. The cases four seen in Rochester, N.Y., and two in Los Angeles closely resemble two additional cases in San Francisco that were reported previously in the journal. In each case an extensive battery of blood tests ruled out the usual causes of purpura.

The cases were reported by the University of Rochester Medical Center and the University of California, Los Angeles.

Because testing for traces of levamisole in the blood is complex and unreliable, researchers cannot say for sure that it is the direct cause of purpura in these instances. But, due to the striking similarity of these cases, and the presence of another condition caused by levamisole called agranulocytosis low blood counts that up the risk of infection in the majority of the patients, doctors say there is strong reason to suspect the drug and to focus greater attention on what could become a widespread health concern.

"We believe these cases of skin reactions and illnesses linked to contaminated cocaine are just the tip of the iceberg in a looming public health problem posed by levamisole," said the study authors.

According to Mary Gail Mercurio, M.D., an author and associate professor in the Department of Dermatology at the University of Rochester Medical Center, "When we first started seeing these patients they all had a similar clinical picture, but they were really an enigma because they weren't falling into any other pattern we'd seen before. When a colleague at the National Institutes of Health mentioned levamisole contamination, we did toxicity screens and lo-and-behold, all the patients came up positive for cocaine. We had our diagnosis."

Drug enforcement officials have detected levamisole which was once used to treat colon cancer in cocaine since 2003, but have watched it increase rapidly in recent years. The Drug Enforcement Administration says that the drug, which is inexpensive, is used more and more as a diluting agent in order to stretch supplies. Study authors report that levamisole is known to increase dopamine, a neurotransmitter that helps control the brain's reward and pleasure centers, causing experts to believe it is added to cocaine to further enhance or prolong the user's high, as well.

Researchers don't know how levamisole causes purpura, which occurs when vessels become plugged and blood can't flow to the skin, leading to skin death and the resulting purplish, crusty appearance. Cocaine alone constricts blood vessels, which is probably the first step, but how levamisole contributes is not yet understood, Mercurio said.

Both smoking and snorting tainted cocaine can lead to purpura and both men and women can be affected. Treatment options include steroids to prevent inflammation, but stopping the exposure to cocaine is the best medicine: Mercurio and the other study authors observed that once patients stopped using cocaine, the purpura and low blood counts improved.

"We've seen a lot of cases in Rochester alone, so it is important to alert the gatekeepers of medicine, the primary care physicians who are in the trenches every day, of this diagnosis," said Mercurio. "This is one of those entities that with familiarity and recognition can go a long way in helping physicians to quickly make a diagnosis and intervene without embarking on an elaborate workup where nothing will pan out."


Contact: Emily Boynton
University of Rochester Medical Center

Related biology news :

1. Nationwide study finds US meat and poultry is widely contaminated
2. 26 percent of herbs eaten in Spain are contaminated with bacteria
3. New technology to speed cleanup of nuclear contaminated sites
4. Using plants against soils contaminated with arsenic
5. Predicting amount of oil in contaminated soils
6. Scrubbing chemical-contaminated buildings clean with lasers
7. Little melamine appears in eggs from chickens on highly contaminated feed
8. Storm runoff and sewage treatment outflow contaminated with household pesticides
9. Smokeless tobacco called moist snuff is contaminated with harmful substances
10. Contaminated site remediation: Are nanomaterials the answer?
11. Contaminated drinking water at Camp Lejeune -- Report release June 13
Post Your Comments:
(Date:12/1/2015)... Calif. , Dec. 1, 2015 Synaptics ... human interface solutions, today announced a new agreement with ... OEMs with real-world test and development environments that combine ... solutions. The partnership reduces the complexity of FIDO certification ... software permits Synaptics and OEMs to verify FIDO enabled ...
(Date:11/30/2015)... BEACH, Fla. , Nov. 30, 2015 /PRNewswire/ ... as a finalist in this year,s Fierce Innovation Awards:  ... of FierceHealthIT , FierceHealthcare ... was recognized as a finalist in the category ... --> ...
(Date:11/26/2015)... Research and Markets ( ) has ... - Technology and Patent Infringement Risk Analysis" report ... --> Fingerprint sensors using capacitive technology represent ... sensor vendor Idex forecasts an increase of 360% of ... and of the fingerprint sensor market between 2014 and ...
Breaking Biology News(10 mins):
(Date:12/1/2015)... -- Twist Bioscience, a company focused on synthetic DNA, today announced ... selected as one of Foreign Policy,s 100 Leading ... of life . Each year, Foreign Policy selects ... have changed lives and are shaping the world. ... to be recognized among these incredible global leaders," said Leproust. ...
(Date:12/1/2015)... 2015 Oxford Finance LLC ("Oxford"), a specialty ... and healthcare services companies, today announced the closing of ... Inc. ("the Company"). Proceeds from the loan are being ... Company,s Rejuvaphyl™ and daily skincare products. ... brand of high potency skincare products that contain the ...
(Date:12/1/2015)... Dec. 01, 2015 ... of the "2016 Europe Cell Surface ... Technologies, Competitive Strategies, Opportunities for Suppliers--France, Germany, ... offering. --> ) has ... Europe Cell Surface Markers: Country Volume and ...
(Date:12/1/2015)... ... December 01, 2015 , ... Park Systems , ... add-on scanning ion conductance microscopy module to Park NX10 that is the only ... Park SICM benefits virtually all materials characterization that require measurements in liquid such ...
Breaking Biology Technology: