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J Forensic Sci. 2019 Jul;64(4):1281-1282. doi: 10.1111/1556-4029.13999. Epub 2019 Jan 15.

Swollen Lips After a Night of Partying-An Allergic Reaction to Ecstasy?

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Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Butenfeld 34, 22529, Hamburg, Germany.
Institute of Legal Medicine, Forensic Toxicology, Faculty of Medicine, University of Cologne, Melatenguertel 60-62, 50823, Cologne, Germany.


Ecstasy (MDMA) is a mood-lifting drug with numerous somatic side effects, for example, dehydration or continuous chewing and biting. We describe the case of a young woman who underwent a forensic medical examination for suspected sexual assault. She claimed to have suffered from a memory lapse, and she had a painful swelling of her lips with a plaque-like coating on her lips and buccal mucosa. The attending physician suspected that these findings might have been caused by strong sucking pressure on her lips within the context of a sexual assault. A toxicological examination of a blood specimen verified that she had been under the influence of an extremely high dose of ecstasy (1.456 mg/L MDMA and 0.0213 mg/L MDA). Pursuant to the forensic medical assessment, the described findings on her lips, and buccal mucosa were interpreted as an allergic and mechanical reaction (through continuous chewing and biting) to ecstasy.


MDMA ; adverse effects; angioedema; ecstasy; forensic science; sexual assault

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