Thirty million Americans have used cocaine, making the United States the world’s largest consumer of the substance there are about 5 million current users. Management strategies include making the diagnosis, gaining knowledge of the disorders that cocaine can mimic, and testing for cocaine and levamisole contaminant. Cocaine may have deleterious effects on the cardiovascular system. Cocaine-induced midline destructive lesions have been associated with cocaine. Levamisole was recently found to contaminate up to 70% of cocaine samples it has been postulated to cause various cutaneous lesions. Whether cocaine itself or in combination with host proteins is immunogenic and whether such a phenomenon has clinical relevance is unclear. The principal effects of cocaine are seen in the CNS and the corticomesolimbic dopamine reward pathway. Recognition of these syndromes is important for appropriate diagnosis and management because they often are confused and misdiagnosis results. ABSTRACT: Cocaine has been implicated in many rheumatologic conditions.
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