From the Guidelines
There is no direct evidence to suggest a relationship between cocaine use and the development of pyoderma gangrenosum. The provided evidence does not mention cocaine use as a factor in the development of pyoderma gangrenosum.
Key Points
- Pyoderma gangrenosum (PG) is a condition that shares clinical features with hidradenitis suppurativa (HS), including similar demographic composition and response to tumor necrosis factor (TNF) inhibitors 1.
- The prevalence of PG among patients with HS ranges from 0.2% to 0.4%, and is higher (3.7%) among patients with HS having Crohn’s disease (CD) 1.
- The association between HS and PG is independent of CD status, with an adjusted odds of having PG up to 20 times greater among patients with HS compared to control individuals 1.
- PG can occur anywhere on the body, including the genitalia, but the commonest sites are on the shins and adjacent to stomas, often preceded by trauma at the site through a phenomenon known as pathergy 2.
Clinical Considerations
- The development of pyoderma gangrenosum is more closely associated with conditions like hidradenitis suppurativa and Crohn’s disease, rather than cocaine use.
- Clinicians should be aware of the potential for PG in patients with HS or CD, and monitor for signs and symptoms of the condition.
- Treatment of PG typically involves a combination of wound care and immunosuppressive therapy, but the provided evidence does not support a specific treatment approach for cocaine-induced PG.
From the Research
Relationship Between Cocaine Use and Pyoderma Gangrenosum
- Cocaine use has been associated with the development of pyoderma gangrenosum (PG), a rare and severe inflammatory skin condition 3, 4, 5, 6, 7
- Studies have reported cases of multifocal and refractory PG in individuals with a history of cocaine use, suggesting a possible role of cocaine abuse in the development of the condition 3, 4, 5
- The temporal relationship between disease outbreaks and cocaine consumption, as well as improvement after discontinuation of cocaine use, has been observed in some cases 3, 6
- Levamisole, an adulterant commonly found in cocaine, has been implicated as a potential cause of PG in individuals who use cocaine 5, 6
- Treatment of cocaine-induced PG typically involves a combination of wound care, immunosuppressive therapy, and counseling for cocaine cessation 5, 6
- The Naranjo score, used to assess the probability of an adverse drug reaction, has indicated a definite adverse drug reaction for cocaine-induced PG in some cases 7