Cutaneous Manifestations Associated With Substance Use Disorders

April 2025 in “ JAAD reviews. ”

S. Matar, N. Dupin, Anne‐Cécile Petit, Raphaël Gaillard, S. Aractingi, Bénédicte Oulès

cutaneous manifestations substance use disorder intravenous drug use vascular complications lymphatic complications skin infections inflammatory responses foreign body responses dermatopsychiatric approach

TLDR Skin issues can signal substance use, helping early detection and treatment.

Substance use disorder (SUD) is linked to various skin manifestations that can indicate the type of substance used or its administration method. Intravenous drug use often results in vascular and lymphatic complications and skin infections. Specific drugs cause distinct skin conditions, such as cannabis-related acne and alopecia, hallucinogen-induced acne-like rashes, and stimulant-related retiform purpura and ulcers. Opioids can cause pruritus and thrombotic microangiopathy, while heroin use may lead to ulcers and candidiasis. The document stresses the importance of dermatologists in identifying these lesions for early SUD detection and management, recommending a multidisciplinary approach involving dermatopsychiatric care.

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