RT Book, Section A1 Frank, Nicholas A1 Hennings, Cara A1 Miller, Jami L. A2 Kang, Sewon A2 Amagai, Masayuki A2 Bruckner, Anna L. A2 Enk, Alexander H. A2 Margolis, David J. A2 McMichael, Amy J. A2 Orringer, Jeffrey S. SR Print(0) ID 1161333430 T1 Drug Abuse T2 Fitzpatrick's Dermatology, 9e YR 2019 FD 2019 PB McGraw-Hill Education PP New York, NY SN 9780071837798 LK accessmedicine.mhmedical.com/content.aspx?aid=1161333430 RD 2025/02/13 AB AT-A-GLANCEDrug use is a growing problem in the United States and around the world. There are many cutaneous findings that suggest use, abuse, and addiction to drugs.Specific findings in affected patients include dental caries, madarosis, presence of scarring, tattooing, and staining in the skin.Levamisole causes a unique syndrome characterized by retiform purpura of the ears associated with neutropenia, perinuclear antineutrophil cytoplasmic antibody and anti-MPO3 antibodies.Less-specific findings of drug use include morbilliform eruptions, vasculitis, and formation of autoantibodies.Drug-use–related infections predominantly affect the skin and soft tissues. Staphylococcal species are the most common organisms, followed by streptococcal species, oral pathogens, and Candida.Other sequelae of drug use include increased risk of infections including HIV, hepatitides B and C, and syphilis.