Meeting abstract

https://doi.org/10.24869/spsih.2026.196

Spontaneous Noninfectious Ulcerative Skin Lesions as a Complication of Methamphetamine Use – A Case Report

Nika Sutara ; University Psychiatric Hospital Vrapče, Zagreb, Croatia *
Mislav Gušćić ; University Psychiatric Hospital Vrapče, Zagreb, Croatia
Petra Obadić ; University Psychiatric Hospital Vrapče, Zagreb, Croatia
Zvonimir Sušić ; University Psychiatric Hospital Vrapče, Zagreb, Croatia
Ivan Ćelić ; University Psychiatric Hospital Vrapče, Zagreb, Croatia
Petrana Brečić ; University Psychiatric Hospital Vrapče, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia

* Corresponding author.

Abstract

Introduction: Methamphetamine is a potent psychostimulant
that acts by increasing the synaptic
concentrations of dopamine, norepinephrine,
and serotonin. Its pronounced sympathomimetic
effect causes systemic and peripheral vasoconstriction
and microcirculatory disturbance, and
together with its neurotoxic effects can lead to
various dermatological complications. While
pruritus, excoriations, and delusional infestation
are well-described consequences of methamphetamine
use, in recent years there has been growing
recognition of spontaneous noninfectious ulcerative
and papulopustular skin lesions that are
not the result of skin-picking, but are thought to
arise from the direct effects of methamphetamine
on the skin and microvasculature. Case report: A
43-year-old patient was hospitalized for treatment of opioid, cocaine, and methamphetamine
dependence. He was a long-term heroin user on
methadone substitution therapy, with occasional
cocaine use. Four months prior to admission, he
began smoking crystal meth (methamphetamine)
every two to three weeks. Along with insomnia,
he noticed the appearance of skin wounds, which
he had not had previously. At admission, multiple
rounded eroded papules and superficial ulcerations
covered with hemorrhagic crusts were
present on the dorsum of the hands, forearms,
and lower legs, accompanied by postinflammatory
hyperpigmentation. The patient reported
that the lesions had resolved spontaneously
since he stopped using methamphetamine. Discussion:
The pathogenesis of spontaneous skin
lesions associated with methamphetamine use
has not been fully clarified. It is considered that
marked sympathomimetic vasoconstriction and
disruption of microcirculation, with consequent
local skin ischemia, play an important role, along
with a possible direct cytotoxic effect of methamphetamine
on the skin and impairment of
wound-healing processes. A clinically significant
temporal relationship between consumption and
the onset of lesions, as well as their resolution
during abstinence, further supports this association.
Conclusion: Spontaneous skin lesions are
a rare and insufficiently recognized complication
of methamphetamine use. Their recognition may
serve as a valuable clinical indicator of active
consumption, thereby avoiding unnecessary diagnostic
procedures and contributing to earlier
engagement of patients in treatment.

Keywords

methamphetamine; skin lesions; ulcerations; dependence

Hrčak ID:

352325

URI

https://hrcak.srce.hr/352325

Publication date:

15.6.2026.

Article data in other languages: croatian

Visits: 0 *