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The Drug-Induced Respiratory Disease Website

Philippe Camus, M.D.

Dijon, France

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Levamisole

4

X.ad Skin purpura, ecchymoses or necrosis

3
Last update : 03/01/2014
 
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Identify causative drugs
Diagnosing DIRD
1
Drug and radiation history
2
Drug singularity - Correct identification of the drug
3
Consistent timing of exposure v. onset of symptoms
4
Clinical, imaging, BAL, pathological pattern consistent with the specific drug
5
Careful exlusion of another cause
6
Remission of symptoms with removal of drug
7
Recurrence with rechallenge (rarely advisable)
8
Causality assessment
More detailed checklist
See also under
Aminorex
5
Cocaine
5
Crack cocaine
5
Levamisole-adulterated/tainted cocaine
5

Publications

Levamisole-Induced Vasculitis: A Characteristic Cutaneous Vasculitis Associated With Levamisole-Adulterated Cocaine.
Archives of pathology & laboratory medicine 2015 Aug;139;1058-61 2015 Aug
[Agranulocytosis and vasculitis in a cocaine addict: levamisole, the hidden culprit].
La Revue de medecine interne 2014 Oct;35;676-9 2014 Oct
Levamisole-induced occlusive necrotising vasculitis in cocaine abusers: an unusual cause of skin necrosis and neutropenia.
International wound journal 2013 Oct;10;590-6 2013 Oct
How to spot cocaine-induced pseudovasculitis.
Annals of plastic surgery 2013 Mar;70;375-8 2013 Mar
Cutaneous vasculopathy and neutropenia associated with levamisole-adulterated cocaine.
The American journal of the medical sciences 2013 Jan;345;45-51 2013 Jan
Reticular rash, cocaine, and levamisole.
Mayo Clinic proceedings 2013 Feb;88;e19 2013 Feb
Plasmapheresis and steroid treatment of levamisole-induced vasculopathy and associated skin necrosis in crack/cocaine users.
Journal of cutaneous medicine and surgery 2013;17;123-8 2013
Levamisole-induced leukocytoclastic vasculitis and neutropenia in a patient with cocaine use: an extensive case with necrosis of skin, soft tissue, and cartilage.
Addiction science & clinical practice 2012 Sep 24;7;19 2012 Sep 24
Limited cutaneous vasculitis associated with levamisole-adulterated cocaine.
Journal of clinical medicine research 2012 Oct;4;358-9 2012 Oct
Levamisole-induced vasculitis with ecchymosis and necrosis syndrome from contaminated cocaine.
BMJ case reports 2012 Nov 21;2012; 2012 Nov 21
Levamisole in cocaine: unexpected news from an old acquaintance.
Clinical toxicology (Philadelphia, Pa.) 2012 Apr;50;231-41 2012 Apr
Characteristic purpura of the ears, vasculitis, and neutropenia--a potential public health epidemic associated with levamisole-adulterated cocaine.
Journal of the American Academy of Dermatology 2011 Oct;65;722-725.e2 2011 Oct
Five consecutive cases of a cutaneous vasculopathy in users of levamisole-adulterated cocaine.
Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases 2011 Jun;17;193-6 2011 Jun

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