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Crack cocaine is a cheaper and more potent version of cocaine prevalent in lower socioeconomic classes. Numerous dermatological manifestations of cocaine abuse have recently been mentioned, including pyoderma gangrenosum and Raynaud’s phenomenon, to name a few [1-3]. We report the case of a 38-year-old male chronically abusing crack cocaine for the past 5 years, displaying blackened punctiform hyperkeratotic lesions on the palms and the ventral surfaces of the fingers, a condition known as crack hands [2]. These lesions are more evident in the dominant hand, which, in this case, is the left hand (Fig. 1). Burns on the hands along with callus or blister formations on the thumb are due to the act of igniting cocaine pipe lighters, the latter known as a crack thumb [3]. Such blister formation can, indeed, be seen in this case of chronic cocaine abuse (Fig. 2).

Crack hands and crack thumbs in chronic cocaine abuse