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Cocaine-related retiform purpura
Cocaine-related retiform purpura
Clinical features Over the past few years, there has been an epidemic form of vasculitis/ vasculopathy related to illicit cocaine use.1โ17 Patients typically present with retiform purpura on extremities and trunk that is temporally related to cocaine use (Fig. 16.134). Involvement of the ears is common and a clue to
Histologic features The pathology is characterized by organizing thrombus with variable inflammation. One case report highlights negative immunoreactivity for podoplanin in the affected vessels suggesting that Mondor disease is related to vascular thrombosis rather than representing a lymphangitis.13
Fig. 16.134 Cocaine-related retiform purpura: (A) retiform purpura with associated epidermal necrosis; (B) this patient had purpuric lesions of the ears. By courtesy of Anthony P. Fernandez, MD, PhD, Cleveland Clinic, Cleveland, USA.