The scars on the patient’s arms were highly suggestive of skin popping. She subsequently admitted to skin popping cocaine, which leaves round, depressed scars. The patient indicated that she had given up trying to find veins for injecting cocaine and had begun injecting directly into her skin. The local skin necrosis caused round scars with skin atrophy.
The unusual pattern of skin scars provided the FP with an opportunity to discuss the patient’s cocaine use and its relationship to the palpitations she had been experiencing.
Photos and text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. This case was adapted from: Usatine, R. Injection drug use. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. The Color Atlas of Family Medicine. New York, NY: McGraw-Hill; 2009:1006-1009.
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