Violaceous nodules of the extensor joints - a clinicopathological challenge

Int J Dermatol. 2025 Jan;64(1):82-84. doi: 10.1111/ijd.17447. Epub 2024 Aug 26.

Abstract

Antineutrophilic cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a condition characterized by vessel inflammation and may have a variety of etiologies. Among these, cocaine and its common adulterant, levamisole, have been described to contribute to the development of AAV with distinct cutaneous manifestations. Classically, these manifestations involve purpuric or necrotic lesions involving the ears, nose, and extremities. However, we present a case of cocaine-induced AAV presenting with violaceous nodules on the dorsal hands in order to demonstrate that this condition may not always present with retiform purpura and skin necrosis.

Keywords: ANCA‐associated vasculitis; levamisole; multicentric reticulohistiocytosis.

Publication types

  • Case Reports

MeSH terms

  • Antibodies, Antineutrophil Cytoplasmic / analysis
  • Antibodies, Antineutrophil Cytoplasmic / blood
  • Cocaine-Related Disorders* / complications
  • Humans
  • Levamisole / adverse effects
  • Vasculitis / diagnosis
  • Vasculitis / pathology

Substances

  • Antibodies, Antineutrophil Cytoplasmic
  • Levamisole