Injection of illicit drugs into the granulation tissue of chronic ulcers.

Chronic skin ulcers are rare among healthy young adults. Local injection of cocaine and heroin has been identified as a cause of chronic skin ulcers in young adults abusing intravenous drugs. These patients use both engorged veins surrounding the ulcers and the granulation tissue itself for the injection of drugs. We believe that chronic skin ulcers in young adults should be a marker for intravenous drug abuse, and should be considered in the differential diagnosis of nonhealing wounds.