To the Editor.—
Schiff and Kern, the authors of "Unusual Cutaneous Manifestations of Pentazocine Addiction" (238:1542-1543, 1977), might be interested in knowing of the report of four other cases of pentazocine skin ulcerations.1 Of interest is the fact that detailed study of pathology sections suggest strongly that the tissue damaged by pentazocine exhibits a specific obliterative vasculitis quite different from the vascular manifestations of other addictive drugs. The clinical finding mentioned by Schiff and Kern—the peculiar woody induration—when taken together with the pathology appears to be pathognomonic for this manifestation of addiction. It is also of interest that all four cases reported in our communication1 were those of physicians or others intimately associated with health care. The initial belief that pentazocine was nonaddictive and advertising to that effect may have stimulated its use in this population.
Cosman B. Cutaneous Manifestations of Pentazocine Addiction. JAMA. 1978;239(5):404. doi:10.1001/jama.1978.03280320020011