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A Case of Cocaine-Induced Pyoderma Gangrenosum With Negative Anti-Neutrophil Cytoplasmic Antibodies
Journal article   Open access   Peer reviewed

A Case of Cocaine-Induced Pyoderma Gangrenosum With Negative Anti-Neutrophil Cytoplasmic Antibodies

Rachel K. Lim, Nicole A. Negbenebor, Erica M. Lin, Sara D. Ragi, Leslie Robinson-Bostom and Cathy M. Massoud
International journal of dermatology and venereology, Vol.9(2), pp.141-143
06/2026
DOI: 10.1097/JD9.0000000000000332
url
https://doi.org/10.1097/JD9.0000000000000332View
Published (Version of record) Open Access

Abstract

Introduction: Cutaneous pyoderma gangrenosum (PG) is an ulcerating autoinflammatory neutrophilic dermatosis often associated with inflammatory bowel disease, hematologic diseases, or arthritis. PG secondary to systemic medications is less commonly reported. PG is a diagnosis of exclusion that requires investigation of other causes of cutaneous ulcers prior to final diagnosis.  Herein, we reported a case of cocaine-induced atypical PG. Case presentation: A 62-year-old man with a medical history of chronic cocaine use presented with recurrent ulcerations limited to the lower extremities and perinuclear anti-neutrophil cytoplasmic antibody negativity following 14 to 15 years of abstinence from cocaine. The diagnosis of PG was made. Clobetasol cream 0.05% was applied twice a day under sterile bandages, resulting in improvement of the lesions. Discussion: PG is a rare autoinflammatory neutrophilic dermatosis and a diagnosis of exclusion because of its nonspecific clinical presentation. Drug-induced PG is less common but presents an opportunity to further research the pathogenesis of PG. Conclusion: This unusual case reinforces that drug-induced PG may have non-classical features and may serve as an indicator of past or present substance abuse, allowing for patient education and counseling.
 Cocaine case report pyoderma gangrenosum negative anti-neutrophil cytoplasmic antibodies

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