Department of Dermatology, Puerta del March University Hospital, Cadiz, Spain.
Clin Exp Dermatol. 2013 Dec;38(8):878-82. doi: 10.1111/ced.12207. Epub 2013 Nov 5.
Cocaine abuse is associated with various skin and rheumatological diseases that mimic primary autoimmune diseases, including retiform purpura with involvement of the ears, cocaine-induced midline destructive lesions (CIMDL), and eruptive pyoderma gangrenosum (PG). Previous reports have suggested the use of perinuclear antineutrophil cytoplasmic antibodies (pANCA) with specificity against human neutrophil elastase (HNE) to differentiate these cocaine-induced diseases from primary autoimmune diseases. We describe a case of a 54-year-old woman with a history of cocaine abuse, who had PG lesions on her legs with accompanying CIMDL and lung lesions similar to those seen in Wegener granulomatosis. Detection of HNE-positive pANCA, and improvement or clinical recurrence after cessation or consumption of cocaine, respectively, were key to differentiating this presentation from primary autoimmune disease.
可卡因滥用与各种皮肤和风湿疾病有关，这些疾病模仿原发性自身免疫性疾病，包括累及耳朵的网状青斑、可卡因诱导的中线破坏性病变（CIMDL）和爆发性坏疽性脓皮病（PG）。先前的报告表明，使用针对人中性粒细胞弹性蛋白酶（HNE）的核周抗中性粒细胞胞质抗体（pANCA）特异性来区分这些由可卡因引起的疾病与原发性自身免疫性疾病。我们描述了一例 54 岁女性，有可卡因滥用史，其腿部有 PG 病变，伴有 CIMDL 和肺部病变，类似于韦格纳肉芽肿所见。HNE 阳性 pANCA 的检测，以及可卡因戒断或消耗后分别的改善或临床复发，是将这种表现与原发性自身免疫性疾病区分开来的关键。
