Memorial Family Medicine Residency, Memorial Hospital, South Bend, IN, USA.
J Am Board Fam Med. 2012 Jul-Aug;25(4):531-5. doi: 10.3122/jabfm.2012.04.110287.
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.
在美国，可卡因与左旋咪唑混合的比例正在稳步上升。在易感人群中，这种药物组合会导致一种临床综合征，包括白细胞减少和皮肤表现。许多患者还表现出自身免疫标志物阳性。皮肤病变的活检通常显示血栓形成模式、白细胞碎裂性血管炎或两者兼有。我们报告了 2 例这种临床现象，其中 1 例严重到需要植皮。临床医生了解这种新出现的公共卫生威胁非常重要。
