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Cocaine mucosal ulcer - Oral Mucosal Lesion
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Cocaine mucosal ulcer - Oral Mucosal Lesion

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Contributors: Vivian Wong MD, PhD, Susan Burgin MD, Carl Allen DDS, MSD, Sook-Bin Woo MS, DMD, MMSc
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Synopsis

Cocaine use is associated with mucosal disease with subsequent painful ulcerations. As cocaine is absorbed through the mucosal membrane, it produces vasoconstriction, anesthesia, and local ischemic necrosis of the mucosal tissue (and sometimes the cartilage and bone). The pathology can occur in multiple organ systems, including the ocular, nasal, oral, and gastrointestinal systems, with serious sequelae such as perforations, fistula, and stricture formation. Agranulocytosis, which can occur secondary to cocaine (and the additive levamisole), contributes to superinfections.

Related topic: Cocaine Use Disorder

Codes

ICD10CM:
T40.5X5A – Adverse effect of cocaine, initial encounter

SNOMEDCT:
403665005 – Drug-induced oral ulceration

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Ocular:
Nasal:
Oral:
Gastrointestinal:

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Updated: 03/30/2017
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Cocaine mucosal ulcer - Oral Mucosal Lesion
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Cocaine mucosal ulcer : cocaine
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