Levamisole: Adulterated Cocaine-Induced Soft Tissue Necrosis

Levamisole can cause severe and rapid onset cutaneous vasculitis. The affected area is frequently small, and conservative management leads to closure of the wounds. In rare occasions, Levamisole-adulterated cocaine could create large areas of necrosis and soft tissue necrosis that require specialized surgical management (McEvenue et al., Surgical management of levamisole-adulterated cocaine induced soft tissue necrosis: case study and treatment algorithm. J Burn Care Res, 38, e638–e646, 2017).