Pentazocine induced skin ulcers: An 'easy to miss' diagnosis
Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh - 160 012
|How to cite this article:
Bhattacharjee R, Mahajan R. Pentazocine induced skin ulcers: An 'easy to miss' diagnosis. Indian J Dermatol Venereol Leprol 2019;85:224-225
A 22-year-old right-handed female presented to the dermatology out-patient department of Postgraduate Institute of Medical Education and Research, Chandigarh, with a one-year history of multiple, painful, well-defined, regular, punched-out ulcers of size approximately 3 × 3 cm with a violaceous hue on the margins and yellowish, purulent slough on the base. The lesions were distributed on all extremities [Figure - 1] and [Figure - 2], but were predominant on the left upper and lower limbs. No venous access could be found as all veins were thickened and fibrosed. Based on these examination findings, a history of repeated injections of pentazocine obtained from the sister and after detailed investigations to rule out alternative diagnoses such as primary vasculitis and pyoderma gangrenosum, a diagnosis of cutaneous ulcers secondary to intravenous drug abuse to pentazocine was made.
|Figure 1: Well-defined, regular, punched-out ulcers on the dorsum of the left hand with a violaceous hue seen along the margins.|
|Figure 2: Similar well-defined, punched-out ulcers present on the left cubital fossa.|
We acknowledge the contribution of Dr. Debajyoti Chatterjee, Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India for providing us with the histopathology photographs.
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