Skin ulcers, itching, blisters, hives, rashes, warts on the nasal mucosa. These skin changes may be triggered because of the consumption of cocaine addiction. If a patient has chronic skin lesions and shows a strange and delusional behavior, should be an overall drug tests to confirm whether the use of this drug is the cause, as recommended by an article published in the Journal of the American Academy of Dermatology.
“However, they must also be completely excluded other triggers of these skin reactions, even when they are illegal substances during testing, since a positive drug test does not always indicate the source of injuries,” warn the authors of the paper, conducted in the Mayo Clinic in Minnesota (USA).
From a social standpoint, “psychoactive drug is any substance that is used outside the law, with strong positive reinforcing action, but with a damaging effect ultimately on the physical or mental health,” says Elena Gonzalez-Guerra, dermatologist at the Foundation Jimenez Diaz de Madrid. Beyond the psychological effects (hallucinations and delusions), its implications on health (stroke, myocardial infarction, hypertensive crisis) also extend to the skin.
Merce Alsina, Dermatology Service of Hospital Clinic of Barcelona, explains that “the use of cocaine can cause dermatological manifestations, as pseudovasculitis, urinary, Churg-Strauss vacuities, Raynaud’s phenomenon, palpable purport, acute generalized exanthemata pustules”.
Names commonly unknown to identify various skin disorders that in many cases, are associated with cocaine use. “There are others such as malformations of the hands in a parrot’s beak and the curvature of the nails, but not always present in all chronic users,” says Dr. Alsina.
Skin involvement is more common drugs that are administered parenterally (injected). Both the abscesses and cellulites occur in 22% to 65% of drug addicts that are managed in this way, “said Gonzalez-Guerra, who adds that, in addition, cocaine users frequently there seborrhea dermatitis hyperkeratosis lesions in the fingers and palms (the outer layer of the skin thickens and becomes hard and rough).
Coetaneous manifestations in real cases
The article in the Journal of the American Academy of Dermatology collects two clinical cases demonstrating the association between cocaine use and skin manifestations.
A 37 year old woman had red lesions on the arms that were extended to the legs and trunk. What at first seemed scabies (the patient did not respond to appropriate treatment), it turned out to be a consequence of cocaine use, as confirmed by the urine test. “She presented excoriated erythematous papules, some with crusts on the tibia, thighs and forearms. Caries and also had significant weight loss,” the authors explain in the article.
Three months earlier, her husband of 39 years, also went to the doctor for an itchy rash that began on his arms. Later, these eruptions became erythematous papules on the arms, legs, upper arm and buttocks. The test result of urine also tested positive for cocaine.
Precisely because such cases are not very common, to such signals, if, moreover, “the patient shows a strange behavior, with signs of delirium or other psychiatric conditions there should be drug testing to identify cocaine as possible cause, “says Jerry D. Brewer, one of the authors of the article.
Both patients attributed the cause of his injuries a few ‘bugs’ they thought they had seen coming out of his skin. It is what is known as delusions of parasitosis, “the most common psychiatric disorder associated with cocaine use. It is that patients have the false and fixed belief that they are infected with parasites,” said Elena de las Heras, a dermatologist at Hospital Ramon and Cajal in Madrid.
Tags: Blisters, Chronic skin, Cocaine addiction, Dermatology, Health, Hives, itching, Rashes, Skin ulcers
