Systemic sclerosis induced by the use of cocaine: is there an association?
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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.
KeywordsSystemic sclerosis Environmental factors Cocaine Drug-induced scleroderma
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.
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.
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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