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January 1979

Heroin Adulterants and Skin Disease

Arch Dermatol. 1979;115(1):111. doi:10.1001/archderm.1979.04010010077039

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To the Editor.—  While working in Detroit General Hospital during the past three years, I have observed a number of heroin users. Most of them have had the usual tracks, scars, and ulcers. A few of them, however, have had morbilliform and fixed erythemas as well as an occasional vasculitis, none of which were attributed to endocarditis or hepatitis. To better ascertain the possible etiology of these lesions, it was believed that a list of adulterants might prove useful. A call to the police crime laboratory revealed some interesting facts.The heroin in the city is now 0.1% to 1.0% pure heroin owing to heavy enforcement by the drug division. Milk sugar continues to be the major adulterant. Quinine is used only rarely now because of increased cost. Some of the more esoteric substances now being used include procaine hydrochloride, lidocaine (Xylocaine), diphenhydramine hydrochloride (Benadryl), methapyrilene hydrochloride (Dormin), diazepam (Valium),

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