Skin discolouration in cocaine abuse patient
This picture is of a 54 year old lady who presented with the complains of painful, enlarging rashes on her face, ear, breast and the extremities. The toxicological screening was done and her urine was found to be positive for drugs like cocaine and opiates. Urine levamisole level done after 2 days for found positive at 920 ng/ml. Biopsy of the lesions was done which showed purpura along with focal intravascular fibrin formation. These findings pointed towards vaculopathy. Management was started using methylpredisolone and prednisolone but no improvement was seen. She then underwent extensive debridement of the necrotic tissue. The findings were found to be related to harmful effects of levamisole, bone marrow suppression and ANCA-positive vaculopathy. Levamisole is an additive agent in the cocaine that is responsible for the euphoric effects. The patient underwent multiple reconstructive surgeries and her case was also complicated by the wound infections. Credits: @hidocdr (via Instagram) https://www.instagram.com/p/CPJZh33BNHl/?utm_medium=copy_link
After debridement pictures? Giving a steroid was a shot in dark. What happened to pt?
How long did she survive and the surgeries, was it a fast progression or did the patient ignore it till it was too late for fear of immediate stop of illegal drugs.
