Abstract
Background: Levamisole is an increasingly common cutting agent used with cocaine. Both cocaine and levamisole can have local and systemic effects on patients.
Methods: A retrospective case series was conducted of patients with a cocaine-induced midline destructive lesion or levamisole-induced vasculitis, who presented to a Dundee hospital or the practice of a single surgeon in Paisley, from April 2016 to April 2019. A literature review on the topic was also carried out.
Results: Nine patients from the two centres were identified. One patient appeared to have levamisole-induced vasculitis, with raised proteinase 3, perinuclear antineutrophil cytoplasmic antibodies positivity and arthralgia which improved on systemic steroids. The other eight patients had features of a cocaine-induced midline destructive lesion.
Conclusion: As the use of cocaine increases, ENT surgeons will see more of the complications associated with it. This paper highlights some of the diagnostic issues and proposes a management strategy as a guide to this complex patient group. Often, multidisciplinary management is needed.
Original language | English |
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Pages (from-to) | 440-446 |
Number of pages | 7 |
Journal | Journal of Laryngology and Otology |
Volume | 134 |
Issue number | 5 |
Early online date | 20 May 2020 |
DOIs | |
Publication status | Published - 20 May 2020 |
Keywords
- Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis
- Cocaine
- Deformities
- Nasal Obstruction
- Nose