Cutaneous Manifestations of Systemic Infections
These include bacteraemia, endocarditis, osteoarthritis and systemic candidosis. Bacteraemia is a life-threatening complication of drug injection. Fifty per cent of the bacteraemia in drug addicts is caused by Staph. aureus. Cutaneous infections, septic thrombophlebitis and endocarditis are the main sources of bacteraemia.[2,5,103] Endocarditis is more frequently a right-sided endocarditis.[1,2,103,104,105,106]Staph. aureus bacteraemia and endocarditis may present with purpura, pustules and limb ischaemia caused by peripheral embolism and septic vasculitis.[104,107] Bacteraemia can cause secondary septic arthritis. The costochondral articulations are usually involved in IDUs.[2,108,109]
Systemic candidosis is the most common fungal systemic infection in IDUs. After 1980 a syndrome including cutaneous, ocular (chorioretinitis or uveitis) and osteoarticular involvement (mainly costochondral) was described in subjects injecting brown heroin diluted with lemon juice.[109,110,111] Typical cutaneous manifestations included painful nodules and pustules mainly located on the scalp and hair-bearing area.[109,110,111] Costochondral involvement may present as a mass or a tumour in the anterior region of the thorax usually without inflammatory signs.
The British Journal of Dermatology. 2004;150(1) © 2004 Blackwell Publishing
Cite this: Cutaneous Complications of Intravenous Drug Abuse - Medscape - Jan 01, 2004.