Atypical ulcerations

Pentazocine‐induced ulcers revisited

“…One unusual report concerned a patient who received pentazocine injections for 20 years but in whom ulcers developed nine years after the injections were stopped . It was suggested that the deposition of crystals from IM injections of pentazocine resulted in late fibrosis and calcification, leading to an inflammatory response over a long period in this patient . All of these observations cannot be explained by any single mechanism of those hypothesized above, which also fail to explain the occurrence of cutaneous lesions in areas far from the injection site .…”

“…Their animal experiments failed to show prominent vascular changes in fibrosed muscles . One unusual report concerned a patient who received pentazocine injections for 20 years but in whom ulcers developed nine years after the injections were stopped . It was suggested that the deposition of crystals from IM injections of pentazocine resulted in late fibrosis and calcification, leading to an inflammatory response over a long period in this patient .…”

“…attributed the cutaneous alterations to frequent and massive doses of parenteral pentazocine for prolonged periods. However, total pentazocine dosages in patients with cutaneous changes have varied from 60 to 2400 mg/d, and the total time interval from the start of injections to the development of cutaneous changes has ranged from two weeks to 29 years . Ulceration was reported in a 45‐year‐old woman treated with 180 mg pentazocine per day after just two weeks .…”