Cutaneous Crospovidone: A Newly Described Foreign Body Due to Illicit Drug Abuse. 2019

Brian S Hoyt, and Denise M Aaron, and Shaofeng Yan, and Konstantinos D Linos
Department of Surgery, Section of Dermatology, Dartmouth-Hitchcock Medical Center, Lebanon, NH.

Crospovidone, a polymer of poly N-vinyl-2-pyrrolidone, is an inert insoluble disintegrant found in pharmaceutical tablets. This material has been encountered in the lungs of intravenous drug users and embolized with other components such as talc and microcrystalline cellulose. More recently, crospovidone has also been described in the gastrointestinal tract. We present 2 cases of cutaneous crospovidone deposition resulting from subcutaneous injection of crushed tablets, commonly known as "skin popping." Clinical presentation includes painful, inflamed papules, nodules, or ulcers with overlying eschar. Crospovidone has a distinct and reproducible histochemical staining profile. Histologic recognition of this material is important because it can guide clinicians in their diagnosis and management decisions.

UI MeSH Term Description Entries
D007279 Injections, Subcutaneous Forceful administration under the skin of liquid medication, nutrient, or other fluid through a hollow needle piercing the skin. Subcutaneous Injections,Injection, Subcutaneous,Subcutaneous Injection
D009293 Opioid-Related Disorders Disorders related to or resulting from abuse or misuse of OPIOIDS. Opiate Addiction,Opiate Dependence,Opioid Misuse,Opioid Use Disorder,Prescription Opioid Abuse,Prescription Opioid Misuse,Addiction, Opioid,Dependence, Opioid,Opiate Abuse,Opioid Abuse,Opioid Addiction,Opioid Dependence,Abuse, Opiate,Abuse, Opioid,Abuse, Prescription Opioid,Addiction, Opiate,Dependence, Opiate,Disorder, Opioid Use,Misuse, Opioid,Misuse, Prescription Opioid,Opiate Abuses,Opioid Abuse, Prescription,Opioid Abuses,Opioid Addictions,Opioid Dependences,Opioid Misuses,Opioid Related Disorders,Opioid Use Disorders,Opioid-Related Disorder,Prescription Opioid Abuses,Prescription Opioid Misuses
D010592 Pharmaceutic Aids Substances which are of little or no therapeutic value, but are necessary in the manufacture, compounding, storage, etc., of pharmaceutical preparations or drug dosage forms. They include SOLVENTS, diluting agents, and suspending agents, and emulsifying agents. Also, ANTIOXIDANTS; PRESERVATIVES, PHARMACEUTICAL; COLORING AGENTS; FLAVORING AGENTS; VEHICLES; EXCIPIENTS; OINTMENT BASES. Aids, Pharmaceutic,Aids, Pharmaceutical,Pharmaceutical Aids
D011205 Povidone A polyvinyl polymer of variable molecular weight; used as suspending and dispersing agent and vehicle for pharmaceuticals; also used as blood volume expander. Polvidone,Polyvidon,Polyvinylpyrrolidone,Arufil,Bolinan,Bolinan 40,Crospovidone,Dulcilarmes,Duratears Free,Enterodes,Enterodez,Hypotears,Kollidon,Lacophtal,Lacri-Stulln,Lagrifilm,Liquifilm Lagrimas,Nutrivisc,Oculotect,PVP 40,Periston,Plasdone,Polyplasdone XL,Povidone, Unspecified,Protagens,Protagent,Unifluid,Vidirakt S mit PVP,Vidisic PVP Ophtiole,Wet-Comod,Dulcilarme,Enterode,Hypotear,Polyvidons,Protagen,Unspecified Povidone
D004339 Drug Compounding The preparation, mixing, and assembly of a drug. (From Remington, The Science and Practice of Pharmacy, 19th ed, p1814). Drug Formulation,Drug Preparation,Drug Microencapsulation,Pharmaceutical Formulation,Compounding, Drug,Formulation, Drug,Formulation, Pharmaceutical,Microencapsulation, Drug,Preparation, Drug
D005260 Female Females
D005547 Foreign Bodies Inanimate objects that become enclosed in the body. Foreign Objects,Gossypiboma,Retained Surgical Instruments,Retained Surgical Items,Retained Surgical Needle,Retained Surgical Sponge,Retained Surgical Tools,Textiloma,Bodies, Foreign,Body, Foreign,Foreign Body,Foreign Object,Gossypibomas,Object, Foreign,Objects, Foreign,Retained Surgical Instrument,Retained Surgical Item,Retained Surgical Needles,Retained Surgical Sponges,Retained Surgical Tool,Surgical Instrument, Retained,Surgical Instruments, Retained,Surgical Item, Retained,Surgical Items, Retained,Surgical Needle, Retained,Surgical Needles, Retained,Surgical Sponge, Retained,Surgical Sponges, Retained,Surgical Tool, Retained,Surgical Tools, Retained,Textilomas
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000701 Analgesics, Opioid Compounds with activity like OPIATE ALKALOIDS, acting at OPIOID RECEPTORS. Properties include induction of ANALGESIA or NARCOSIS. Opioid,Opioid Analgesic,Opioid Analgesics,Opioids,Full Opioid Agonists,Opioid Full Agonists,Opioid Mixed Agonist-Antagonists,Opioid Partial Agonists,Partial Opioid Agonists,Agonist-Antagonists, Opioid Mixed,Agonists, Full Opioid,Agonists, Opioid Full,Agonists, Opioid Partial,Agonists, Partial Opioid,Analgesic, Opioid,Full Agonists, Opioid,Mixed Agonist-Antagonists, Opioid,Opioid Agonists, Full,Opioid Agonists, Partial,Opioid Mixed Agonist Antagonists,Partial Agonists, Opioid

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