Skin is an important focus for toxin-related bacterial infections. Tetanus is a rare but regularly reported complication in IDUs.[1,112,113,114] Anaerobic infections, repeated septic needle injuries, chronic wounds and under-immunization render IDUs at risk for tetanus. In Italy injection drug use is the main risk factor among young individuals. Systematic vaccination is recommended for IDUs.
Wound botulism has been reported in IDUs both in the U.S.A. and Europe.[115,116,117] A recent epidemic occurred in California associated with the subcutaneous or intramuscular injection of 'black tar' heroin.[115,116,117]
A recent case of cutaneous anthrax complicated by meningitis in a heroin skin-popper has been reported in Norway. Exceptional cases of toxic shock syndrome attributed to the direct intravenous inoculation of Staph. aureus toxin at the time of heroin injection, and staphylococcal scalded skin syndrome have been reported.[119,120,121]
Other cutaneous manifestations have been reported where the causal relationship with drug use is not clear, including cases of polyarteritis nodosa[122,123] and scleroderma.[124,125,126] Needle fragment foreign bodies after needle breakage are occasionally found in the skin.[13,58,127]
The British Journal of Dermatology. 2004;150(1) © 2004 Blackwell Publishing
Cite this: Cutaneous Complications of Intravenous Drug Abuse - Medscape - Jan 01, 2004.