'Skin popping' of the foot by drug abusers

NewsBot · Feb 22, 2014

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Demographic description of the presentation and treatment of lower extremity skin and soft tissue infections secondary to skin popping in intravenous drug abusers.
Pirozzi K1, Van JC1, Pontious J2, Meyr AJ3.
J Foot Ankle Surg. 2014 Mar-Apr;53(2):156-9.

Skin popping refers to the act of subcutaneous injection of intravenous drugs, a practice that often results in the development of cellulitis and the formation of soft tissue abscesses. Although the foot and ankle represent common injection sites, few data have described the presentation and natural history of this pathologic entity. The objective of the present study was to retrospectively assess the descriptive demographic data of a patient cohort admitted for lower extremity skin and soft tissue infection caused by intravenous drug abuse. Fifty skin popping lesions in 49 patients were identified during a 733-day data collection period (August 1, 2010 to August 31, 2012) that had been treated by the in-patient podiatric surgical service for lower extremity infection caused by intravenous drug abuse at an urban, level-one trauma center. With respect to patient race, our hospital has a typical in-patient census of 55% black patients and 25% white patients. The present patient cohort consisted of 12% black patients and 65% white patients. The mean length of stay was 5.71 ± 3.56 days, and 42 patients (85.71%) underwent some form of surgical debridement, with 31 (63.27%) having undergone a formal procedure in the operating room. Six patients (12.24%) left the hospital against medical advice or refused intervention at some definitive point of care, and 36 (73.47%) did not return for scheduled outpatient follow-up visits. Three cases (6%) resulted in minor amputation. The microbiologic culture data and common antibiotic prescriptions used in the diagnosis and treatment, respectively, of these patients have been summarized. We hope these original descriptive data can be used by other physicians treating patients at similar urban practices to improve the care of these sometimes difficult-to-treat patients and better serve this population as a whole.
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Nellermoe · Feb 24, 2014

My experience in injected drug abusers is there is a high incidence of osteomyelitis affecting the tarsal bones of the foot. The infection source is the infected drug injection sight. Most skin poppers are doing so to use the drugs after the veins in the extremities have scarred down due to repeated injection. That or the drug user is trying to avoid the characteristic track marks on arms and legs.

NewsBot · Dec 6, 2014

Podiatric Problems and Management in Patients with Substance Abuse
Gabriel V. Gambardella D.P.M., Chioma N. Odukwe Enu D.P.M., Brian M. Schmidt D.P.M., Peter A. Blume D.P.M.
Substance Abuse; 2015, pp 515-536

Patients typically seek treatment from a podiatric surgeon to relieve pain, whether acute from a traumatic event or chronic from long-standing or unaddressed pathology. When conservative treatment fails to provide patient satisfaction, surgical intervention becomes necessary and the surgeon must then be prepared to address acute postsurgical pain, which can be more challenging in patients with a history of substance abuse. Through meticulous surgical technique, understanding lower extremity pathomechanics, and employing sufficient perioperative analgesia, we can provide superb outcomes for our patients and prevent chronic postsurgical pain. Furthermore, there exist a variety of signs and symptoms about the foot and ankle that may indicate substance abuse when correlated with the patient’s history, and it is imperative for the podiatric surgeon to have an awareness of these clinical presentations to provide the best possible treatment.
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NewsBot · Mar 12, 2015

Lower extremity manifestations of “skin-popping” an illicit drug use technique: A report of two cases
Michael Canales, John Gerhard, Erin Younce
The Foot; Article in Press

Highlights
•As states crack down on “pill mills”, many areas of the country have seen a resurgence of intravenous drug use and overdoses.
•The skin popping technique can lead to devastating consequences for intravenous drug users.
•To effectively treat these patients requires a team approach to manage both social and medical issues.
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Presented is a rare case of tibial and fibular osteomyelitis and a case of fibular periositis, both a direct consequence of a peculiar drug use technique. The osseous manifestations secondary to presentation of necrotic wounds with indurated rim and serous drainage with associated cellulitis, both resulting from “Skin Popping.” Due to the complex treatment plan required, the importance of a motivated patient, a strong social support system, a controlled environment, and a multidisciplinary team cannot be overstated. Despite comprehensive efforts, devastating consequences may be unavoidable as individuals plunge downward, victimized by their addiction.
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'Skin popping' of the foot by drug abusers

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'Skin popping' of the foot by drug abusers

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