Levamisole-Adulterated Cocaine These rashes are typical for the leukocytoclastic vasculitis produced by levamisole exposure. Levamisole is physically similar to cocaine and its postulated mechanisms of action include: - Decreased catecholamine degradation in the synapse - Independent stimulatory effects - Potentiate and prolong the action of cocaine via anticholinesterase activity Levamisole exposure is associated with multiple cutaneous manifestations including: - Vasculitis - Purpuric lesions - Skin necrosis - Urticaria - Bullae - Dermatitis The face and ears are commonly affected, although lesions can appear anywhere. Patients may describe fevers, malaise, fatigue, sore throat, oral ulcers, and joint pain. #Clinical #Derm #Rash #Levamisole #Cocaine #LeukocytoclasticVasculitis
