Sánchez-Puigdollers A, Just-Sarobé M, Pastor-Jané L
Servicio de Dermatología, Hospital Universitari Joan XXIII, Tarragona, España.
Servicio de Dermatología, Hospital Universitari Joan XXIII, Tarragona, España.
Actas Dermosifiliogr. 2023 Feb;114(2):125-131. doi: 10.1016/j.ad.2022.09.005. Epub 2022 Sep 14.
Cocaine and some of its main adulterants, such as levamisole, can cause multiple cutaneous and mucosal manifestations, including ischemic complications, neutrophilic dermatoses, midline destructive lesions, and vasculitis associated with antineutrophil cytoplasmic antibodies (ANCAs). Striking systemic symptoms are generally not seen. In all these conditions, positive test results may be observed for antinuclear antibodies, antiphospholipid antibodies, and various ANCAs, sometimes with characteristic staining patterns. Histology typically shows vascular changes, such as leukocytoclastic vasculitis, necrotizing vasculitis, and thrombi. We review the clinical, serologic, and histologic features of cutaneous and mucosal conditions associated with the use of cocaine and also look at pathophysiologic mechanisms, differential diagnoses, and treatments.
可卡因及其一些主要掺杂物，如左旋咪唑，可引发多种皮肤和黏膜表现，包括缺血性并发症、嗜中性皮病、中线破坏性病变以及与抗中性粒细胞胞浆抗体（ANCA）相关的血管炎。通常未见明显的全身症状。在所有这些情况下，抗核抗体、抗磷脂抗体及各种ANCA检测结果可能呈阳性，有时还伴有特征性染色模式。组织学检查通常显示血管改变，如白细胞破碎性血管炎、坏死性血管炎和血栓形成。我们回顾了与使用可卡因相关的皮肤和黏膜疾病的临床、血清学及组织学特征，并探讨了其病理生理机制、鉴别诊断和治疗方法。
