{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T22:12:47Z","timestamp":1783807967308,"version":"3.55.0"},"reference-count":30,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,6,29]],"date-time":"2022-06-29T00:00:00Z","timestamp":1656460800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dermatopathology"],"abstract":"<jats:p>The use of levamisole as the most frequent adulterant of cocaine has merged in previously unknown toxicities, notably a disease entity called cocaine\/levamisole-associated autoimmune syndrome (CLAAS). Clinically, CLAAS can manifest with diverse cutaneous and extracutaneous features sharing common laboratory findings (neutropenia, autoantibody patterns). We report the case of a cocaine-abusing female patient with relapsing episodes of painful ulcers, worsening and expanding over a three-year period. The case exhibited all features of a drug-induced, skin-limited, ANCA-associated vasculitis, evolving over time to PG-like findings. In both disease stages, the patient responded well to the cessation of cocaine exposure and systemic glucocorticosteroids. This case demonstrates the continuous nature of cutaneous CLAAS manifestations in a single patient. CLAAS has become a major public health issue in the at-risk group of cocaine users, and clinicians should be alert of this condition when treating cocaine users presenting with single or multiple skin ulcerations.<\/jats:p>","DOI":"10.3390\/dermatopathology9030026","type":"journal-article","created":{"date-parts":[[2022,6,29]],"date-time":"2022-06-29T20:47:56Z","timestamp":1656535676000},"page":"207-211","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Cocaine\/Levamisole-Induced, Skin-Limited ANCA-Associated Vasculitis with Pyoderma Gangrenosum-like Presentation"],"prefix":"10.3390","volume":"9","author":[{"given":"Mirjana","family":"Urosevic-Maiwald","sequence":"first","affiliation":[{"name":"Haut\u00e4rzte-Zentrum am Z\u00fcrisee, 8008 Zurich, Switzerland"},{"name":"Faculty of Medicine Zurich, University Zurich, 8032 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan-Hendrik B.","family":"Hardenberg","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University Hospital Zurich, 8091 Zurich, Switzerland"},{"name":"Department of Nephrology and Intensive Care Medicine, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, 10117 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrg","family":"Hafner","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8607-6254","authenticated-orcid":false,"given":"Marie-Charlotte","family":"Br\u00fcggen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Zurich, University Zurich, 8032 Zurich, Switzerland"},{"name":"Department of Dermatology, University Hospital Zurich, 8091 Zurich, Switzerland"},{"name":"Medical Campus Davos, Swiss Institute of Allergy Research (SIAF), 7265 Davos, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"231","DOI":"10.3109\/15563650.2012.665455","article-title":"Levamisole in cocaine: Unexpected news from an old acquaintance","volume":"50","author":"Larocque","year":"2012","journal-title":"Clin. 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