Vaskulitis der Haut nach Kokainkonsum

Zusammenfassung

Anamnese und klinischer Befund Ein 20-jähriger Patient stellte sich mit großflächigen und äußerst schmerzhaften Purpura mit Nekrosearealen und Vesikeln, v.a. an den unteren Extremitäten, aber auch an den Armen, am Stamm und an den Ohren in unserer Notaufnahme vor. Vorbestehend war ein Konsum von Kokain.

Untersuchungen In den Laboruntersuchungen zeigten sich erhöhte Entzündungszeichen sowie eine Erhöhung der Proteinase 3- und Myeloperoxidase-ANCA (Anti-Neutrophile cytoplasmatische Antikörper).

Diagnose In Zusammenschau der Anamnese, des klinischen Befundes und der Laborwerte zeigte sich eine Vaskulitis der Haut nach Kokainkonsum.

Therapie und Verlauf Unter einer Therapie mit Steroid sowie Drogenkarenz kam es zu einer Rückbildung der Veränderungen.

Folgerung Die Vaskulitis ist eine schwerwiegende Komplikation der Einnahme von Kokain.

Abstract

History and clinical findings A 20-years-old patient presented himself to our emergency room with extensive and extremely painful purpura with necrotizing spots and blisters, especially on the lower extremities, but also on the arms, trunk and ears. There was a pre-existing use of cocaine.

Medical examinations Laboratory tests showed increased signs of inflammation as well as an increase in proteinase 3- and myeloperoxidase-ANCA (Anti-neutrophil cytoplasmatic antibody).

Diagnosis In combination with the medical history, the clinical findings, and the laboratory values, vasculitis of the skin after cocaine use was revealed.

Therapy and course Under therapy with steroids and cocaine abstinence, there was a regression of the changes.

Conclusion Vasculitis is a serious complication of cocaine use.

Schlüsselwörter

Kokain - Levamisol - Vaskulitis - ANCA - Nekrose

Keywords

Cocaine - Levamisole - vasculitis - ANCA - necrosis

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