Summary
Injection drug abuse is a world-wide problem responsible for numerous minor to life-threatening and fatal complications. The skin is the tissue most evidently affected by intravenous drug addiction. A wide spectrum of cutaneous complications may occur in intravenous drug users. These include acute or delayed local complications, hypersensitivity reactions, cutaneous manifestations of systemic infections or becoming the site of toxigenic infections. Between 1996 and 2001, in our institution in south-eastern France, we observed cutaneous complications after crushed buprenorphine tablet injections in 13 patients. This paper reviews and classifies adverse effects of parenteral drug abuse on the skin.
Introduction
Injection drug abuse is a world-wide problem responsible for numerous minor to life-threatening and fatal complications. These complications depend mainly on the drug, the dose injected, the method of delivery, the site of injection and the presence of infectious agents. Overdose and the transmission of blood-borne infections such as human immunodeficiency virus (HIV) and hepatitis viruses B and C through sharing unsterile injection equipment are well known risks of injection drug abuse. All intravenous drug users (IDUs) have cutaneous adverse effects during their addiction. Weidman and Fellner. found that 86% of subjects attending a medical clinic for drug addicts had cutaneous adverse effects. Only a few authors have previously described some of the cutaneous complications caused by parenteral drug abuse. A recent outbreak of cutaneous complications following the misuse of buprenorphine oral tablets in our institution in south-eastern France, provided an opportunity to study the subject. This paper reviews and classifies the cutaneous manifestations related to intravenous drug use.