Cocaine-induced midline destructive lesions

Cocaine-induced midline destructive lesions, abbreviated CIMDL, are the progressive destruction of the structures of the nose that follows prolonged insufflation of cocaine, colloquially called snorting. The damage begins with erosion of the mucosal lining and then advances to the cartilage and bone, eroding the palate, the nasal conchae and the ethmoid sinuses. It is a recognized example of a lesion caused by a drug taken by a route that repeatedly injures the tissue it touches, and it is described in the Medicine Atlas as a condition of the nose and upper airway with an environmental toxin as its cause.