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Skin popping (SP) is a popular technique for drug misuse, for its ease of administration and longer duration of effect. Skin infection is a well-described sequela of SP, but less is known about the more extreme sequelae of this practice. Five patients who engaged in SP requiring major surgical intervention were identified on case review to highlight extreme diseases resulting from the practice of SP. Each patient reported using heroin or tested positive for opioid on admission. Each patient admitted to practicing SP or maintained a shoote

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