We thank Helander et al for sharing their fascinating MT-45 (1-cyclohexyl-4-(1,2-diphenylethyl)piperazine) cases (Br J Dermatol 2016 Dec 14. https://doi.org/10.1111/bjd.15174. [Epub ahead of print]). MT-45 is a piperazine derivative and was investigated as an opioid analgesic in the 1970s. Laboratory studies suggest its pharmacology is complex and involves opioid receptors and non-opioid targets. MT-45 has emerged on the new psychoactive substances market where it is mostly sold on the Internet.
