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November 2010

Levamisole-Induced Cutaneous Necrosis Mimicking Coagulopathy

Author Affiliations

Author Affiliations: Department of Dermatology, Henry Ford Hospital, Detroit, Michigan.

Arch Dermatol. 2010;146(11):1320-1321. doi:10.1001/archdermatol.2010.335

Levamisole was initially discovered as an anthelmintic agent in the 1960s. It was subsequently found to have immunomodulatory effects and was used in the treatment of nephritic syndrome, colon cancer, and rheumatoid arthritis. Recently, attention has been focused on the use of levamisole as a cutting agent in cocaine after reports of agranulocytosis associated with the drug. In addition to agranulocytosis, levamisole has been linked to cutaneous vasculitis.1,2 We report herein 2 cases of cutaneous necrosis associated with cocaine use that are most likely from levamisole contamination.

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