Author

No. Cases

Time Since Cocaine Use

Treatment

Outcome

Ching et al¹²

1

3 weeks

Topical sulfamylon, excision, and grafting

Failure, left leg amputation and upper lip excision (F)

Jacob et al²¹

2

1) Unspecified

2) Immediately before onset

1) 80 mg prednisone daily

2) 40 mg prednisone

1) Resolution (I)

2) Fled hospital, presented 10 days later with resolution (R)

Ulrich et al⁹

5

1) Unspecified

2) Unspecified

3) Unspecified

4) Unspecified

5) Unspecified

1) 20 mg prednisone daily

2) High dose steroids and cyclophosphamide

3) Low-dose prednisone

4) Low-dose prednisone

5) Steroids and cyclophosphamide

1) Initial improvement, symptoms return following prednisone taper (I)

2) Improvement of symptoms and normalization of antibodies

3) Rapid improvement (R)

4) Improvement of symptoms (I)

5)  Lost to follow-up (U)

Zwang et al¹⁰

1

Tox screen positive

60 mg prednisone daily

Follow-up displayed marked improvement (I)

Fthenakis & Klein²²

1

Immediately before onset

Abstinence

Spontaneous remission (R)

Mouzakis et al²³

1

Unspecified

Methylprednisone and silver sulfadiazine dressings

Minimal response, debridement and allograft placement required (F)

Gross et al²⁴

4

1) Unspecified

2) Unspecified

3) Tox screen positive

4) 48 hours

1) 60 mg prednisone daily

2) Abstinence

3) 30 mg prednisone daily

4) 60 mg prednisone daily

1) Lost to follow-up (U)

2) Initial improvement (I)

3) Improved symptoms 1 week later (I)

4) Lost to follow-up (U)

Click²⁵      

1

Unspecified

Skin grafting

Grafts healing on follow-up (I)

Chung et al¹¹

6

1) Unspecified

2) Tox screen positive

3) Tox screen positive

4) Tox screen positive

5) Tox screen positive

6) Tox screen positive

1) Steroids

2) IV antibiotics with filgrastim

3) IV methylprednisolone

4) IV methylprednisolone

5) Supportive

6) Antibiotics

1) Lost to follow-up (U)

2) Gradual improvement, relapse with cocaine use (I)

3) Initial improvement (I)

4) Rapid improvement of lesions and neutropenia (R)

5) Rapid improvement of lesions (R)

6) Rapid improvement of lesions and associated symptoms (R)

Reutemann et al⁵

1

Less than 24 hours

Not Reported

Not Reported (U)

Bradford et al⁴

2

1) 4 days

2) Unspecified

1) Filgrastim

2) Steroids

1) Spontaneous resolution of lesions (R)

2) Rapid improvement of lesions and neutropenia (R)

Walsh et al²

2

1) Unspecified

2) Unspecified

1) Surgical debridement with skin graft

2) Abstinence

1) Improvement of symptoms (I)

2) No improvement of symptoms due to cocaine use (F)

Jenkins et al⁶

1

24 hours

Oral and topical steroids, aspirin, and pentoxfylline

Lesions resolved over 3 months, presented with similar symptoms after cocaine use (I)

Dy et al⁷

1

24 hours

1 mg/kg/day prednisone

Skin lesions and neutropenia improved in 2 weeks (R)

Farhat et al²⁶

2

1) Tox screen positive

2) Tox screen positive

1) Pain control

2) Not Reported

1) Not Reported (U)

2) Not Reported (U)

Geller et al²⁷

1

Weeks prior to onset

Not Reported

Not Reported (U)

John et al²⁸

1

Less than 24 hours

Skin emollients and pain control

Readmitted 10 days after discharge for worsening symptoms following cocaine use (F)

Waller et al²⁹

2

1) Tox screen positive

2) Unspecified

1) Not Reported

2) Not Reported

1) Not Reported (U)

2) Not Reported (U)

UMMC Cases

4

1) 5 days

2) 48 hours

3) 24 hours

4) Could not be elicited

1) Petrolatum and gauze dressing, surgical removal of index finger

2) Silvasorb© gel with gauze dressings

3) Gauze dressings, mupirocin, and 60 mg prednisone taper

4) Petrolatum and gauze dressings

1) Lesions stable at discharge, instructed to follow-up (U)

2) Significant improvement of lesions (I)

3) No follow-up available (U)

4) No follow-up available (U)

Graf et al³⁰

6

1) Tox screen positive

2) Tox screen positive

3) Tox screen positive

4) Tox screen positive

5) Tox screen positive

6) Tox screen positive

Not Reported for All Cases

Not Reported (U)

Han et al³¹

1

Unspecified

IV steroids and dalteparin

Initial improvement, recurrence of symptoms with cocaine use (I)

de la Hera et al³²

1

72 hours

Not Reported

Follow-up three weeks later showed improvement, appeared later with similar lesions after cocaine use (I)

Poon et al⁸

4

1)Unspecified

2) Unspecified

3) 24 hours

4) Unspecified

1) Naproxen, antibiotics, and prednisone

2) Colchicine 0.6 mg daily

3) Ibuprofen

4) Abstinence

1) Slow improvement of mucocutaneous ulcers (I)

2) Improvement of skin lesions (I)

3) Improvement of skin lesions (I)

4) Improvement of skin lesions (I)

Khan et al

4

1) Unspecified

2) Unspecified

3) Tox screen positive

4) Tox screen positive

1) Prednisone 40 mg/day

2) Prednisone 40 mg/day and methotrexate 7.5 mg/week

3) Prednisone 40 mg/day

4) Antibiotics

1) Improvement of symptoms (I)

2) Improvement of symptoms (I)

3) Improvement of symptoms (I)

4) Unclassified (U)