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      Fingertip and nasal tip thermal burn in crack cocaine user * Translated title: Queimadura da polpa digital e da ponta nasal em usuário de crack

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          Abstract

          Crack cocaine addiction is a public health problem in Brazil. It is an endemic disease that affects rural and urban areas. The Ministry of Health has launched emergency programs for the treatment of dependents and to combat drug trafficking. Recognition of dermatological signs of this disease is important because through them the diagnosis can be suspected and early treatment of patients with crack cocaine addiction be provided.

          Translated abstract

          A dependência química do crack é um problema de saúde pública no Brasil. Trata-se de uma endemia que afeta a zona rural e a zona urbana. O Ministério da Saúde lançou programas emergenciais para o tratamento dos dependentes e o combate ao tráfico de drogas. Reconhecer os sinais dermatológicos iniciais desta doença é importante, pois através deles, pode-se suspeitar do diagnóstico e então proporcionar ao paciente o tratamento precoce.

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          Crack whips the heart: a review of the cardiovascular toxicity of cocaine.

          Deepak Thatai, Luis O B Afonso, T. Mohammad (2007)
          Cocaine is an extremely powerful reinforcing psychostimulant with highly addictive properties. Over the last few decades, cocaine addiction has attained epidemic proportions in North America, imposing a tremendous burden on society and the health care system. The cardiovascular complications of cocaine abuse are adrenergic mediated and range from cocaine-associated acute coronary syndromes to aortic dissection and sudden cardiac death. Concomitant alcohol and cigarette smoking exacerbate the cardiotoxicity of cocaine. This contemporary review discusses the spectrum of cardiac complications arising from cocaine use, operant pathophysiologic mechanisms and controversies surrounding the pharmacotherapy of cocaine-associated acute coronary syndromes.
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            Pseudosclerodermatous triad of perniosis, pulp atrophy and 'parrot-beaked' clawing of the nails--a newly recognized syndrome of chronic crack cocaine use.

            J.J. Payne-James, M.H.W. Munro, C.M.E. Rowland Payne (2007)
            The number of people dependent on crack-cocaine in the UK has increased substantially in recent years. Some crack-cocaine users develop coarsening changes in the appearance of their hands after prolonged use of the drug. These changes have most often been recognized in females and include: (i) Perniosis with cold, numb hands, sometimes with perniotic hyperkeratosis over the knuckles.(ii) Finger pulp atrophy of the distal part of the pulps of some digits, especially the thumbs and index fingers.(iii) Claw-like curvature of the nails. As the distal pulp is lost, it can no longer splint the nail straight and so the nail curves, claw-like, and reminiscent of a parrot's beak as it clings to the new contour. As the pulp atrophy progresses, the nail eventually also becomes smaller.This triad may be due to ischemia consequent upon peripheral vasoconstriction induced by crack-cocaine. Early changes may resolve with abstinence. In the patients described the syndrome does not appear to be to related to intravenous drug usage. It may occur without concomitant use of heroin, whether smoked or via the intravenous route. The syndrome does not occur in all crack-cocaine users. It is hypothesized that those with a vasoreactive circulation (i.e., those with vasomotor instability/perniosis) are more susceptible to this reaction pattern. The syndrome consisting of the triad of perniosis, pulp atrophy and parrot-beaked clawing of the nails should alert the clinician to the possibility of prolonged crack-cocaine misuse.
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              Crack hands: a dermatologic effect of smoking crack cocaine.

              C M Feeney, S Briggs (1992)
              We have seen multiple cases of a characteristic skin lesion produced by smoking crack cocaine. We describe a typical case with photographs demonstrating multiple blackened hyperkeratotic lesions of the palmar aspects of the fingers and palm, some linear, some circular. These involve mostly the dominant hand and are caused by the heat of the glass cocaine pipe.
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                Author and article information

                Journal
                Journal ID (nlm-ta): An Bras Dermatol
                Journal ID (iso-abbrev): An Bras Dermatol
                Journal ID (publisher-id): An Bras Dermatol
                Title: Anais Brasileiros de Dermatologia
                Publisher: Sociedade Brasileira de Dermatologia
                ISSN (Print): 0365-0596
                ISSN (Electronic): 1806-4841
                Publication date (Print): Sep-Oct 2013
                Volume: 88
                Issue: 5
                Pages: 850-852
                Affiliations
                [1 ] Graduate Dermatology student at the Institute of Dermatology Professor Rubem David Azulay - Charity Hospital of Rio de Janeiro - Rio de Janeiro (RJ), Brazil.
                [2 ] Graduate Interventionist Cardiology and Hemodynamics student at Hospital São Francisco Saúde of Ribeirão Preto - Ribeirão Preto (SP), Brazil.
                [3 ] Dermatologist - Private Practice - Ituiutaba (MG), Brazil.
                [4 ] Specialist in Ophthalmology, Service of Ophthalmology at the Regional Hospital of Presidente Prudente - State University of the West of São Paulo (UNOESTE) - Presidente Prudente (SP), Brazil.
                [5 ] PhD in Dermatology - Head of the Dermatology Service of Regional Hospital of Presidente Prudente - State University of the West of São Paulo (UNOESTE) - Presidente Prudente (SP), Brazil.
                Author notes
                MAILING ADDRESS:Fred Bernardes Filho, Rua Marquês de Caxias, 9 Sobrado - Centro, 24030-050 - Niterói - RJ, Brazil, E-mail: f9filho@ 123456gmail.com
                Article
                DOI: 10.1590/abd1806-4841.20132821
                PMC ID: 3798375
                PubMed ID: 24173204
                SO-VID: 65d83c74-77ce-401f-9c4e-cf2975ffae86
                Copyright © ©2013 by Anais Brasileiros de Dermatologia
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 25 May 2013
                Date accepted : 17 July 2013
                Categories
                Subject: Iconography

                Keywords: cocaine-related disorders,crack cocaine,drug toxicity,hand dermatoses
                Data availability:
                Keywords: cocaine-related disorders, crack cocaine, drug toxicity, hand dermatoses

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