Cocaine use is associated with mucosal disease with subsequent painful ulcerations. As cocaine is absorbed through the mucosal membrane, it produces vasoconstriction, anesthesia, and local ischemic necrosis of the mucosal tissue (and sometimes the cartilage and bone). The pathology can occur in multiple organ systems, including the ocular, nasal, oral, and gastrointestinal systems, with serious sequelae such as perforations, fistula, and stricture formation. Agranulocytosis, which can occur secondary to cocaine (and the additive levamisole), contributes to superinfections.

Related topic: cocaine intoxication and use disorder, cocaine levamisole toxicity