Dermatologic Complications of Heroin Addiction

Cutaneous complications of intravenous drug abuse

“…However, in some cases infection may contribute to the formation of ulcerated lesions even though it is difficult to demonstrate the respective contribution of each factor. 53 Indeed Hoeger et al 55 reported a synergistic cocaine and streptococcal cutaneous necrosis. Some bullous lesions, nodules and chemical cellulitis and abscesses share identical physiopathology and may precede necrosis and ulceration.…”

“…3). 31,[48][49][50][51][52][53][54] For example, quinine used as an adulterant has caustic effects. In addition some drugs such as cocaine have potent vasoconstrictive and thrombotic effects.…”

“…Although bacteria may be cultivated from necrotic ulcers, most authors consider the mechanism to be related not to an infection but to a direct effect of the drug or adulterants. However, in some cases infection may contribute to the formation of ulcerated lesions even though it is difficult to demonstrate the respective contribution of each factor 53 . Indeed Hoeger et al 55 .…”

Penile and scrotal skin necrosis after injection of crushed buprenorphine tablets

“…Del Giudice et al reported a similar case of cutaneous necrosis after buprenorphine injection into the pudendal artery in a 25-year-old woman [2]. Other reported complications after groin/genitalia drug injection include ecthyma gangrenosum [4], Fournier's gangrene [3], and penile ulcers [6][7][8]. In the latter situation, drug abusers may have tried to inject heroin directly in the dorsal vein of the penis.…”

“…In the latter situation, drug abusers may have tried to inject heroin directly in the dorsal vein of the penis. Extravasation of the material is then complicated by penile ulcer [6][7][8]. Buprenorphine chlorhydrate is a semisynthetic partial opioid agonist designed for sublingual administration, used in Europe for substitution treatment in opiate addiction.…”