“…Palatal perforations have been seen, in varying degrees, in other circumstances, including cocaine abuse, syphilis, cancer, and rheumatological diseases, such as Wegener's granulomatosis (Ramstad et al, 1980;Kasifoglu and Cansu, 2008;Silvestre et al, 2010;Song et al, 2011). The infant's mother had a history of cocaine abuse during pregnancy but reports indicate that it is the direct vasoconstrictive effect of inhaled cocaine that contributes to tissue ischemia and perforation (Silvestre et al, 2010).…”