Conflict of interest: none declared.
Clinical dermatology ● Concise report
Pyoderma gangrenosum and Wegener granulomatosis-like syndrome induced by cocaine
Article first published online: 5 NOV 2013
© 2013 British Association of Dermatologists
Clinical and Experimental Dermatology
Volume 38, Issue 8, pages 878–882, December 2013
How to Cite
Jiménez-Gallo, D., Albarrán-Planelles, C., Linares-Barrios, M., Rodríguez-Hernández, C., Martínez-Rodríguez, A., García-Moreno, E. and Bravo-Monge, R. (2013), Pyoderma gangrenosum and Wegener granulomatosis-like syndrome induced by cocaine. Clinical and Experimental Dermatology, 38: 878–882. doi: 10.1111/ced.12207
- Issue published online: 20 NOV 2013
- Article first published online: 5 NOV 2013
- Manuscript Accepted: 27 MAR 2013
Cocaine abuse is associated with various skin and rheumatological diseases that mimic primary autoimmune diseases, including retiform purpura with involvement of the ears, cocaine-induced midline destructive lesions (CIMDL), and eruptive pyoderma gangrenosum (PG). Previous reports have suggested the use of perinuclear antineutrophil cytoplasmic antibodies (pANCA) with specificity against human neutrophil elastase (HNE) to differentiate these cocaine-induced diseases from primary autoimmune diseases. We describe a case of a 54-year-old woman with a history of cocaine abuse, who had PG lesions on her legs with accompanying CIMDL and lung lesions similar to those seen in Wegener granulomatosis. Detection of HNE-positive pANCA, and improvement or clinical recurrence after cessation or consumption of cocaine, respectively, were key to differentiating this presentation from primary autoimmune disease.