VASCULITIS ATTRIBUTED TO THE NICOTINE PATCH (NICOTINELL)

Nicotine-containing patches are used to facilitate tobacco withdrawal by mitigating abstinence symptoms and diminishing craving, We describe two patients who developed vasculitis in association with the use of a nicotine patch, The first concerns a patient who developed fever, ar thritis, a generalized erythema and purpuric lesions, after 3 days use of nicotine patches. Laboratory results and a skin biopsy confirmed t he diagnosis of a leucocytoclastic vasculitis, After stopping use of t he patch, the patient recovered. On challenge, the symptoms reappeared . The second patient developed purpuric lesions during the use of nico tine patches, and recovered fully after these were stopped, In these p atients, nicotine patches seem to be causally related to the developme nt of vasculitis.