A Rare Incidence of Necrotizing Lesion of the Upper Arm Due to Pentazocine Injection Abuse: A Case Report

Abstract

A patient with a history of treated pain with intravenous drugs comes at high risk for drug abuse. Administration of intravenous pentazocine continuously for a long time in the same location affected the skin tissue. Pentazocine misuse is frequent among patients with chronic disease conditions and the easy availability of pentazocine injection can easily lead to significant consequences. We present a unique case of pentazocine misuse resulting in significant skin necrosis. We present a case of a 48-year-old male with a complaint of pain and wound with lesions over the arm due to the regular self-administered pentazocine in the same location. The therapeutic intervention given in this case is an opiate agonist to control the dependence on pentazocine.

Xylazine is an agonist at kappa opioid receptors and exhibits sex-specific responses to naloxone administration

“…Our findings carry important clinical and public health implications. Considering that xylazine is a full κOR agonist, we note two prominent historical and international examples of nonmedical use of the κOR agonist pentazocine: the "Ts and Blues" (pentazocine and tripelennamine) outbreak in the midwestern United States from 1977 to 1981 (75-77), and pentazocine injection in Nigeria (78) and India (79)(80)(81)(82). In both settings, characteristic skin lesions beyond the site of injection, eschar formation, and wound cratering were observed (83)(84)(85)(86), with morphological similarity (61) to reports involving xylazine from Puerto Rico (62), the Philadelphia area (16,(63)(64)(65)(66), and New Haven, Connecticut (67).…”

Xylazine is an agonist at kappa opioid receptors and exhibits sex-specific responses to opioid antagonism

“…Our findings carry important clinical and public health implications. Considering that xylazine is a full κOR agonist, we note two prominent historical and international examples of non-medical use of the κOR agonist pentazocine: the “Ts and Blues” (pentazocine and tripelennamine) outbreak in the midwestern United States from 1977 to 1981 [ 77 – 79 ], and pentazocine injection in Nigeria [ 80 ] and India [ 81 – 84 ]. In both settings, characteristic skin lesions beyond the site of injection, eschar formation, and wound cratering were observed [ 85 – 90 ], with morphological similarity [ 91 ] to reports involving xylazine from Puerto Rico [ 92 ], the Philadelphia area [ 9 , 93 ], and New Haven, Connecticut [ 94 ].…”