Patients abusing cocaine or methyl-amphetamine may develop skin excoriations and scarring associated with a creeping sensation on and under the skin.
Clinical features:
(1) abuse of cocaine or methamphetamine
(2) sensation of something creeping on or under the skin, which may be interpreted as being a bug
(3) constant picking at the skin which may take on the appearance of a constant, repetitive behavior
(4) scratching results in excoriations and subsequent scars, some of which may become hyperpigmented
Differential diagnosis:
(1) drug withdrawal
(2) neurosis or phobia (acarophobia = fear of mites)
(3) psychosis, delusions or paranoia
(4) injection site reactions
To read more or access our algorithms and calculators, please log in or register.
Specialty: Dermatology, Toxicology
ICD-10: ,
