The percentage of cocaine adulterated with levamisole is steadily increasing in the United States. In susceptible persons, this combination of drugs leads to a clinical syndrome that can include leukopenia and cutaneous manifestations. Many patients also demonstrate positive autoimmune markers. Biopsies of skin lesions often reveal a thrombotic pattern, leukocytoclastic vasculitis, or both. We report 2 cases of this clinical phenomenon, one of which was severe enough to require skin grafting. It is important for clinicians be aware of this emerging public health threat.

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threat autoimmune leukopenia thrombotic pattern leukocytoclastic

Gerald W, Morris Bryan C, Mason Rachael, Harris Sprunger Holly, Hake Harris Luke A, White Dale A, Patterson,.Levamisole-adulterated cocaine: a case series.. 25 (4),531-5.

Gerald W, Morris Bryan C, Mason Rachael, Harris Sprunger Holly, Hake Harris Luke A, White Dale A, Patterson,"Levamisole-adulterated cocaine: a case series." 25

Gerald W, Morris Bryan C, Mason Rachael, Harris Sprunger Holly, Hake Harris Luke A, White Dale A, Patterson,"Levamisole-adulterated cocaine: a case series."