TY - JOUR T1 - Pain in the pinnae: a sign of levamisole vasculopathy JF - Emergency Medicine Journal JO - Emerg Med J SP - 984 LP - 984 DO - 10.1136/emermed-2012-202203 VL - 30 IS - 11 AU - Barry Ladizinski AU - Kachiu C Lee Y1 - 2013/11/01 UR - http://emj.bmj.com/content/30/11/984.abstract N2 - A 61-year-old man presented with fatigue, arthralgias and a tender rash on his ears in the setting of recent cocaine use. Physical examination revealed purpuric dark purple patches with haemorrhagic bullae on the bilateral helical rims (figures 1 and 2). Laboratory investigation was significant for a serum sodium of 130 mmol/l (normal range, 135–145) and positive perinuclear antineutrophil cytoplasmic … ER -