Cocaine-Related Stevens-Johnson Syndrome

Abstract

We report the case of a 26-year-old student with erosive skin changes on his oral and genital mucosa and skin as well as on his thighs twice after cocaine snorting. The second of these two episodes was documented histologically, and other underlying causes of disease were excluded. A diagnosis of recurring Stevens-Johnson syndrome was made. Treatment was initiated with bed rest, systemic prednisone at 1 mg/kg body weight and liquid nutrition. Mucosal changes resolved within 4 days. On follow-up the patient remained free of symptoms while abstaining from the particular cocaine street mix in question. Cocaine has been involved in seizures, headaches, ischemic strokes, intracerebral hemorrhage, cerebral vasculitis, Churg-Strauss vasculitis, palpable purpura and Henoch-Schönlein vasculitis. Bullous skin disease in association with cocaine has been reported in 1 patient. To our knowledge, we report the first case of Stevens-Johnson syndrome associated with cocaine snorting.

Cocaine abuse: Dermatologic manifestations and therapeutic approaches

“…8,9 In addition to the cutaneous manifestations, cocaine use has also been associated with Stevens-Johnson syndrome, 10 Buerger disease, 11,12 hypertensive crisis, acute myocardial infarction, cerebral vascular accidents, and ventricular arrhythmia. 13 Cocaine has the unusual propensity to cause internal hyperthermia, and it may even cause fatalities when temperature adjustments cannot be made.…”

Spastic Form of Cerebral Palsy, Epilepsy With Benign Epileptiform Discharge of Childhood on Electroencephalogram, and Iatrogenic Stevens–johnson Syndrome (Case Description)

“…Известно, что подобная острая токсико-аллергическая реакция возникает в ответ на введение терапевтической дозы препарата. Чаще всего развитие синдрома вызыва-ют: антибиотики (особенно пенициллинового ря-да) -до 55 %, нестероидные противовоспалитель-ные препараты -до 25 %, сульфаниламиды -до 10 %, витамины и другие средства, влияющие на метабо-лизм, -до 8 %, местные анестетики -до 6 %, дру-гие группы препаратов, в том числе и антиэпилеп-тические, составляют до 18 % [2,[8][9][10]. Подобная атопическая реакция имела место у рассматривае-мого больного в ответ на ламотриджин.…”

Cocaine-Induced Vasculitis: Clinical and Immunological Spectrum

“…Palpable purpura, angioedema, urticaria, formication (i.e. tactile hallucinations of insects crawling underneath the skin) bullous diseases, and Stevens-Johnson syndrome have all been described [6,7]. A clinical characteristic observed is that these manifestations respond to discontinuation of cocaine use, and recur after re-initiation.…”