Cocaine‐induced plasma cell orificial mucositis

Tánago, Begoña Udondo González del; Jiménez‐Gallo, David; Navarro‐Navarro, Irene; Catalina-Fernández, Inmaculada; Ríos‐Martín, J.J.; Linares‐Barrios, Mario

doi:10.1111/jdv.18619

Cited by 4 publications

(6 citation statements)

References 6 publications

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“…It often presents with asymmetry of the nasal passages 2 or severe destruction of the nasal septum. 3 However, the clinical–pathological profile recently presented in the literature 1 is so distinctive that, in the face of the clinical presentation with prolonged erosive thickening of the nasal passages and the upper lip, one of the initial diagnostic suspicions should be this condition. A biopsy can easily confirm the suspicion, especially in the presence of an infiltrate rich in plasma cells and eosinophils.…”

Section: Discussionmentioning

confidence: 99%

“…Given this histopathological scenario and clinical presentation, the condition was highly suggestive of plasma cell mucositis induced by cocaine, as recently described in the literature. 1 Under such suspicion, the patient was requestioned, eventually admitting to prolonged cocaine consumption through snorting.…”

Section: Case Reportmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

“…Recently, there has been reported a novel clinical presentation associated with cocaine abuse, characterized by irregular thickening of the nasal openings and the upper lip. 1 The condition typically begins in the nostril; however, with continued cocaine use, it inevitably extends to involve the upper lip. As discussed later, the lip involvement represents a dermal inflammatory process, characterized by a decreasing density of infiltrate in depth.…”

Section: Introductionmentioning

confidence: 99%

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Cocaine-Induced Plasma Cell Orificial “Dermatomucositis”: A More Accurate Descriptive Term for a Clearly Dermatological Entity

Fernandez-Flores,

González Montero

2024

The American Journal of Dermatopathology

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Although the involvement of the nasal passages and nasal septum in cocaine users has been known for decades, a new presentation affecting the nostrils and upper lip with an inflamed appearance has recently been documented. The authors who identified this presentation termed it “cocaine-related plasma cell mucositis” due to the abundance of plasma cells in the infiltrate. In this article, we present a second case and emphasize the dermal involvement of the lip, leading us to consider the condition as a genuine dermatomucositis.

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Section: Discussionmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cocaine-Induced Plasma Cell Orificial “Dermatomucositis”: A More Accurate Descriptive Term for a Clearly Dermatological Entity

Fernandez-Flores,

González Montero

2024

The American Journal of Dermatopathology

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“…Plasma cell orificial mucositis (PCOM) associated with cocaine is a rare emerging entity that has become a concern in Spain in recent years. Since the first report by Udondo González Del Tánago et al, Spanish dermatologists have identified an additional 9 patients with similar clinical and pathologic features, strengthening the diagnosis of this rising phenomenon among individuals who use cocaine. To increase the understanding of this new condition, we present a case series of 10 patients with cocaine-associated PCOM in Spain.…”

Section: Introductionmentioning

confidence: 99%

Retrospective Case Series of Cocaine-Associated Plasma Cell Orificial Mucositis

Viedma-Martinez,

Gallo-Pineda,

Recio-Monescillo

et al. 2024

JAMA Dermatol

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ImportancePlasma cell orificial mucositis (PCOM) associated with cocaine use is an emerging, rare condition that has become a concern in Spain in recent years. Limited knowledge exists regarding this novel condition.ObjectivesTo delineate the clinicopathologic characteristics of this emerging entity and establish a novel approach in the differential diagnosis of cocaine-associated lesions.Design, Setting, and ParticipantsA descriptive, retrospective, multicenter case series of 10 patients diagnosed with cocaine-associated PCOM was conducted in Spain from April 2020 to March 2023.Main Outcomes and MeasuresPatient demographic, clinical, histopathologic, and treatment data were collected.ResultsA total of 10 patients (6 [60%] male; median [range] age, 45.5 [36-66] years) presenting with exudative ulcerated plaques were identified for this study. The lesions had raised and erythematous edges over the nostril and a median (range) evolution time of 9 (2-24) months. Septal or palate perforations were observed in 4 (40%) of the patients. Biopsies revealed a dense inflammatory infiltrate of plasma cells in the dermis without atypia and with eosinophils. All patients reported recent cocaine use. Three urine tests detected cocaine but found no presence of amphetamines or opiates. Six patients improved with corticosteroid therapy. Up to 60% of patients were lost to follow-up.Conclusions and RelevanceThis case series describes the clinicopathologic characteristics of PCOM, an emerging entity associated with cocaine use in Spain, and demonstrates a novel approach in the differential diagnosis of cocaine-associated lesions. To date, cocaine-associated skin lesions have been reported as neutrophilic dermatoses and vasculitis. The appearance of a plasma cell infiltrate changes what has been described in the medical literature so far. PCOM is a benign condition of unknown cause characterized by a proliferative polyclonal plasma cell infiltrate. A comprehensive differential diagnosis workup is required to reach this exclusionary diagnosis. Several irritants have been documented in cases of PCOM, and a hypersensitivity mechanism has been proposed. Since the initial report of cocaine-associated PCOM in Spain, its incidence has experienced a surge in the country. The cause of this phenomenon may be attributed to newly unidentified adulterants. The administration of corticosteroids and discontinuation of cocaine use are the sole treatments that have demonstrated efficacy. Clinicians should be vigilant regarding this emerging condition and conduct inquiries into cocaine use. Additional research is required to clarify the pathophysiology of this emerging condition.

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Analyses bibliographiques d’EM-dermatologie – Sélection troisième trimestre 2022

Kluger¹,

Cribier²

2022

Annales de Dermatologie et de Vénéréologie - FMC

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Cocaine‐induced plasma cell orificial mucositis

Cited by 4 publications

References 6 publications

Cocaine-Induced Plasma Cell Orificial “Dermatomucositis”: A More Accurate Descriptive Term for a Clearly Dermatological Entity

Cocaine-Induced Plasma Cell Orificial “Dermatomucositis”: A More Accurate Descriptive Term for a Clearly Dermatological Entity

Retrospective Case Series of Cocaine-Associated Plasma Cell Orificial Mucositis

Analyses bibliographiques d’EM-dermatologie – Sélection troisième trimestre 2022

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