Objective: We describe 4 patients who presented with palpable purpura, arthralgia or arthritis, leukopenia, and antineutrophil cytoplasmic antigen (ANCA) positivity most likely as a result of a hypersensitivity reaction to cocaine-levamisole induced vasculopathy.
Methods: Cases were seen and reviewed in both the inpatient consult service and the outpatient clinics at Rhode Island Hospital from August 2009 to August 2010. Clinical characteristics as well as pertinent laboratory parameters were also reviewed and corroborated with a review of the present literature.
Results: We describe 3 cases of cocaine-levamisole-related cutaneous vasculitis with or without associated neutropenia, and 1 case of severe neutropenia with oral mucosal ulceration. Further serologic studies revealed maximum titers of ANCA mostly in a perinuclear pattern. Antimyeloperoxidase tested negative or mildly elevated in our cohort. Three patients with neutropenia had positive antigranulocyte IgM antibody. Nonsteroidal anti-inflammatory drugs were effective as first-line treatment for joint pain. The use of colchicine and systemic corticosteroid was employed to manage severe and persistent skin lesions.
Conclusions: Cocaine-levamisole-related cutaneous vasculitis with leukopenia is a diagnosis of exclusion, but this diagnosis should be strongly considered in patients with a history of cocaine abuse who present with a tetrad of cutaneous manifestations consisting of palpable purpura or bullae with ear involvement, arthralgias, leukopenia, and positive ANCA in high titers and negative Antimyeloperoxidase, when other infectious or idiopathic vasculitic entities have been excluded.
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http://dx.doi.org/10.1016/j.semarthrit.2011.05.009 | DOI Listing |
PLoS One
December 2024
School of Medicine and Health Sciences, Center for Research in Genetics and Genomics (CIGGUR), Institute of Translational Medicine (IMT), Universidad del Rosario, Bogotá D.C., Colombia.
Hereditary angioedema type 1 (HAE1) is a rare, genetically heterogeneous, and autosomal dominant disease. It is a highly variable, insidious, and potentially life-threatening condition, characterized by sudden local, often asymmetric, and episodic subcutaneous and submucosal swelling, caused by pathogenic molecular variants in the SERPING1 gene, which codes for C1-Inhibitor protein. This study performed the phenotypic and molecular characterization of a HAE1 cluster that includes the largest number of affected worldwide.
View Article and Find Full Text PDFJ Family Med Prim Care
November 2024
Department of Dermatology, Venereology and Leprosy, SRM Medical College and Research Centre, Chengalpattu, Tamil Nadu, India.
Systemic lupus erythematosus (SLE) is the prototype of an autoimmune disease with various manifestations in the skin and several other organs. Subacute cutaneous lupus erythematosus may present with annular and psoriasiform lesions. There have been case reports of pustular lesions in SLE.
View Article and Find Full Text PDFImmun Inflamm Dis
December 2024
Department of Rheumatology and Immunology, Huadong Hospital Affiliated to Fudan University, Shanghai, China.
Objective: This study aimed to investigate the efficacy and safety of a triple therapy consisting of colchicine, thalidomide and total glucosides of paeony (TGP) in Behcet's disease (BD) patients with mucocutaneous involvement.
Methods: Totally 355 newly diagnosed BD patients with mucocutaneous involvement were recruited, who received dexamethasone and colchicine for the first 2 weeks, then they were categorized into "sustained triple-therapy (ST)" (n = 231) and "colchicine to triple-therapy (CT)" (n = 124) groups respectively: for ST group, patients received colchicine, thalidomide plus TGP from Month (M)0.5 to M12; for CT group, patients received colchicine from M0.
J Ethnopharmacol
December 2024
Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing, China. Electronic address:
Ethnopharmacological Relevance: Acne vulgaris is a common skin disease affecting the pilosebaceous unit, in which abnormal sebum secretion and inflammation play crucial roles. The traditional Chinese medicine Tanreqing has been utilized in dermatology to effectively treat various diseases. However, its effects and underlying mechanisms in acne vulgaris remain unclear.
View Article and Find Full Text PDFJ Patient Rep Outcomes
December 2024
Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Paul-Ehrlich-Haus, Hindenburgdamm 30, 12203, Berlin, Germany.
Objective: A key component of determining that a patient-reported outcome (PRO) measure is fit-for-purpose is to ensure that respondents understand its instructions and items. Any modification to a measure should be evaluated for relevance and understandability. The objective of the study was to assess comprehension of the adapted Urticaria Activity Score (UAS) questionnaire among adolescents aged populations with chronic spontaneous urticaria (CSU) and the modification to UAS question 2 to include patient-friendly terminology "wheals (hives).
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