Department of Dermatology, Hospital Universitario 12 de Octubre, Madrid, Spain.
Dermatology. 2011;223(1):25-8. doi: 10.1159/000329436. Epub 2011 Aug 16.
BACKGROUND/AIMS: Levamisole is an anthelminthic drug with immunomodulatory properties that has been found to be an adulterant of cocaine in the last 2 years. It was present at least in 70% of tainted cocaine in the U.S.A. in 2009.
We present the case of a 40-year-old patient with a history of weekend cocaine use who consulted for bilateral necrotic lesions in the ears that had appeared 3 days after the last use.
Levamisole causes a typical clinical picture characterized by bilateral necrosis of the ears, positive perinuclear antineutrophil cytoplasmic antibodies and laboratory findings of antiphospholipid syndrome, such as anticardiolipin antibodies and/or lupus anticoagulant.
Dermatologists should be aware of this new entity, which is likely to be more and more frequent due to the increasing use of cocaine. Here we describe a clinical case that is likely to be secondary to levamisole-tainted cocaine and review the literature.
背景/目的：左旋咪唑是一种具有免疫调节特性的驱虫药物，在过去 2 年中已被发现是可卡因的掺杂物。它至少存在于 2009 年美国 70%的受污染可卡因中。
我们报告了一例 40 岁患者的病例，该患者有周末可卡因使用史，在最后一次使用后 3 天出现双侧耳部坏死性病变。
左旋咪唑引起典型的临床特征，表现为双侧耳部坏死、核周抗中性粒细胞胞质抗体阳性以及抗磷脂综合征的实验室发现，如抗心磷脂抗体和/或狼疮抗凝物。
皮肤科医生应该意识到这种新的实体，由于可卡因使用的增加，它可能会越来越频繁。在这里，我们描述了一个可能继发于左旋咪唑污染可卡因的临床病例，并回顾了文献。
