Rheumatology International

, Volume 39, Issue 2, pp 387–393 | Cite as

Systemic sclerosis induced by the use of cocaine: is there an association?

  • Rafael Andreussi
  • Lila Morena Bueno Silva
  • Henrique Carriço da Silva
  • Ana Paula Luppino-Assad
  • Danieli Castro O. Andrade
  • Percival D. Sampaio-BarrosEmail author
Cases with a Message


The association between cocaine abuse and systemic sclerosis (SSc) is rarely described. Two new cases of this association are presented: two young adults, after using inhaled cocaine for a few years, were diagnosed with SSc. While a 24 year-old white female patient presented with diffuse SSc with multiple digital ulcers and scleroderma renal crisis (SRC), a 27 year-old male patient presented limited SSc with skin ulcers and digital gangrene, rapidly evolving to death due to massive intestinal hemorrhage. The authors performed a literature search and found only eight previously published cases. The clinical picture of these patients shows a predominance of vascular involvement, including multiple ulcers and SRC. There is no association with specific SSc autoantibodies. The concomitance of alcohol and other drugs abuse, as well as the presence of drug adulterers, complicates a clear understanding of the role of cocaine in SSc patients.


Systemic sclerosis Environmental factors Cocaine Drug-induced scleroderma 


Author contributions

RA and LMBS collected the data and provided the photographs, analyzed the results and wrote the manuscript, under the guidance of PDSB; APLA, HCS, and DCOA contributed to the writing and critically reviewed the manuscript; PDSB designed, analyzed the results, critically reviewed the manuscript and wrote the final version. All authors read and approved the final manuscript.


No funding was received for this study.

Compliance with ethical standards

Conflict of interest

Dr. Andreussi declares no conflict of interest related to this article. Dr. Bueno Silva declares no conflict of interest related to this article. Dr. Carriço da Silva declares no conflict of interest related to this article. Dr. Luppino-Assad declares no conflict of interest related to this article. Dr. Andrade declares no conflict of interest related to this article. Dr. Sampaio-Barros declares no conflict of interest related to this article.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Written informed consent was obtained from the two patients prior to submission of this article for consideration as a case-based review.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Rheumatology, Hospital das Clinicas HCFMUSP, Faculdade de MedicinaUniversidade de Sao PauloSão PauloBrazil

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