heroin and Mouth-Diseases

Topics: Heroin; Heroin Dependence; HIV Infections; HIV-1; Humans; Methadone; Mouth Diseases; Mouth Mucosa; Narcotics; Risk Factors; Viral Load

Pemphigus vegetans is variant of pemphigus vulgaris accounting for 5% of all patients with pemphigus disorders. We describe a case of pemphigus vegetans-Neumann type associated with intranasal heroin abuse, restricted to the modified mucous membranes. The results of routine histology and direct and indirect immunofluorescence studies confirmed the diagnosis. The patient responded to oral prednisone of 40 mg daily for 1 month, followed by reduction to a maintenance dose of 15 mg daily. A complete remission was sustained for 6 months. The relationship between intranasal heroin use and the development of pemphigus vegetans remains uncertain but appears to be an intriguing possibility in this patient.

Topics: Administration, Intranasal; Adult; Female; Heroin; Heroin Dependence; Humans; Keratosis; Lip Diseases; Mouth Diseases; Narcotics; Nose Diseases; Pemphigus; Tongue Diseases

An immunologic response to the quinine used to "cut" heroin caused oral manifestations of thrombocytopenic purpura. The patient had an admission platelet count of 2,000 per cubic millimeter. Treatment with corticosteroids and withholding of the offending resulted in a platelet count of 265,000 per cubic millimeter 13 days after admission. Oral manifestations of purpura disappeared on the fourth day of treatment.

Topics: Adult; Heroin; Humans; Lip Diseases; Male; Mouth Diseases; Mouth Mucosa; Purpura, Thrombocytopenic; Quinine