jump to content
New York State Office of Alcoholism and Substance Abuse Services Link to NYS Home Page in new browser window Link to New York State Office of Alcoholism and Substance Abuse Services Home Page

Home Resources Addiction Medicine

Skin Manifestations of Cocaine Use

NEW YORK STATE OFFICE OF ALCOHOLISM AND SUBTANCE ABUSE SERVICES
Addition Services for Prevention, Treatment, Recovery

Addiction Medicine FYI

Skin Manifestations of Cocaine Use

Cocaine affects many systems of the body, including the skin (Brewer et al., Journal of the American Academy of Dermatology, 2008):

  • Acute multifocal skin necrosis - pathologic death of skin cells
  • Acute generalized exanthematous pustulosis - eruption of small elevations of skin containing pus
  • Subcutaneous fat necrosis of the newborn - pathologic death of fat cells
  • Cutaneous fibrosis - fibrous tissue formation in the skin
  • Blackened hyperkeratotic palms (“crack hands”) - horny layer of the skin is blackened
  • Chronic skin ulcers
  • Scleroderma - disease where there is thickening of the skin caused by swelling and thickening of the fibrous layer
  • Cocaine - related bullous disease - blebs or enlarged air spaces in the lung
  • Palatal perforation - hole in the palate
  • Dental caries - tooth decay
  • Gingival recession - gums recede
  • Oral blisters
  • Pseudovasculitis - false inflammation of the blood vessels
  • Urticarial vasculitis - hive formation
  • Stevens-Johnson syndrome - a life-threatening condition affecting the skin in which cell death causes the epidermis to separate from the dermal layer of the skin
  • Midline destructive granulomas - nodules that destroy the underlying tissue
  • Churg-Strauss vasculitis - an extremely rare disease that results from inflammation and which causes injury to organ systems.
  • Necrotizing granulomatous vasculitis - destruction of the vascular system by granuloma
  • Schonlein-Henoch vasculitis - A systemic vasculitis that causes the blood vessels in the skin to become inflamed, causing red spots. When the blood vessels in the skin get inflamed, they can bleed, causing a rash that is called purpura.
  • Palpable purpura - hemorrhage into the skin that can be raised and thus felt
  • Necrotizing vasculitis - blood vessels are destroyed
  • Delusional parasitosis - significant itching and excoriations from scratching (see picture #1)
  • Nasal septum perforation (see picture #2)
  • Pott puffy tumor - osteomyelitis of the frontal sinus (see picture #3) - inflammation of the bone marrow and adjacent bone and cartilage
  • Raynaud phenomenon - Rare disorders that affects blood vessels. These disorders are marked by brief episodes of vasospasm (narrowing of the blood vessels - see picture #4)
  • Buergers disease - Thromboangiitis Obliterans  - an inflammatory disease of the small and medium sized arteries and veins of the extremities (see picture #5)
a photograph of a hand covered with dark spots
1. Delusional parasitosis
a photogtraph of a nose showing a hole in the septum
2. Nasal septum perforation
an x-ray showing a tumor in the sinus cavity
3. Pott puffy tumor
a photograph of two hands with the top portion of the fingers appearing to be bleached white
4. Raynaud phenomenon
a photograph of a hand showing the tips of the fingers being dark red
5. Buergers disease

Brewer et al., Journal of the American Academy of Dermatology, 2008