Purpuric skin eruption in an illicit drug user: Levamisole-induced vasculitis.

© 2017 Kristen Whitworth. Cavalieri. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License. The first case connecting vasculitis to levamisole adulterated cocaine was published in 2010. Since that time, there have been numerous case reports of complications arising from levamisole contaminated cocaine. A case report in 2011 suggested the use of the term LINES to describe the levamisole induced syndrome of vasculitis, neutropenia, and purpura resulting in skin necrosis1. The illustrative acronym LINES – levamisole induced necrosis syndrome – was coined as a tongue-and-check reference to the manner cocaine is dosed when used illicitly. While the community is developing a better understanding of this syndrome, other potential complications of levamisole are coming into light.