To report a case of ocular cicatricial pemphigoid caused by levamisole-adulterated cocaine.
Methods:
Case report.
Results:
A 54-year-old woman with multi-systemic levamisole-induced vasculitis which triggered bilateral cicatrizing conjunctivitis refractory to conventional immunosuppressants due to continued cocaine misuse.
Conclusion:
Levamisole-induced vasculitis is a significant public health issue due to its popularity as an adulterant to cocaine. Our report suggests that levamisole caused vasculitis and ocular cicatricial pemphigoid in this case. Ocular manifestation of this syndrome is rare.
LeeKCLadizinskiBFedermanDG. Complications associated with use of levamisole-contaminated cocaine: an emerging public health challenge. Mayo Clin Proc2012; 87(6): 581–586.
2.
AuroaNJaninTBhanotR, et al. Levamisole-induced leukocytoclastic vasculitis and neutropenia in a patient with cocaine use: an extensive case of necrosis of skin, soft tissue and cartilage. Addict Sci Clin Pract2012; 7: 19.
3.
PoonSHBaliogCRSamsRN, et al. Syndrome of cocaine-levamisole-induced cutaneous vasculitis and immune-mediated leukopenia. Semin Arthritis Rheum2011; 41: 434–444.
4.
RameshSSobtiDMaciniR. Eyelid necrosis and secondary cicatricial ectropion secondary to levamisole-associated vasculitis. Ophthalmic Plast Reconstr Surg2017; 33(3SSuppl. 1): S38–S40.
5.
CaldwellKGrahamOArnoldJ. Agranulocytosis from Levamisole-Adulterated Cocaine. J AM Board Fam Med2012; 25(4): 528–530.
6.
KudlacekOHofmaierTLufA, et al. Cocaine adulteration. J Chem Neuronat2017; 83–84: 75–81.
7.
Abdul-KarimRRyanCRangelC, et al. Levamisole-induced vasculitis. Proc (Bayl Univ Med Cent)2013; 26(2): 163–165.
8.
GrossRLBruckerJBahce-AltuntasA, et al. A novel cutaneous vasculitis syndrome induced by levamisole-contaminated cocaine. Clin Rheumatol2011; 30(10): 1385–1392.
9.
GargLGuptaSSwamiA, et al. Levamisole/cocaine induced systemic vasculitis and immune complex glomerulonephritis. Case Rep Nephrol2015; 2015: 372413.
10.
LazarethHPeytavinGPolivkaL, et al. The hairy print for levamisole-induced vasculitis. BMJ Case Rep2012; 2012: bcr2012006602.
