Leukocytoclastic vasculitis (LCV) refers to a histopathological pattern of neutrophil predominant inflammatory process of small vessels associated with fibrinoid
necrosis. Cutaneous LCV usually presents as symmetrically distributed palpable purpuric nodules of the lower extremities with or without systemic involvement. Although 50% of LCV cases are idiopathic, it can be secondary to identifiable causes such as
malignancy, autoimmune conditions,
infections, and medications. Medications have been implicated in up to 25% of cases;
sulfonamides,
NSAIDs, and
beta-lactams have the most frequent association. We herein present a 32-year-old female who developed palpable
purpura over hands and lower limbs 12 days after exposure to
oxacillin administered for
infective endocarditis. Punch biopsy from the skin lesions confirmed the diagnosis of LCV. Given the temporal relationship between
oxacillin administration and development of skin findings, the diagnosis of
oxacillin-associated LCV was suspected. Discontinuation of
drug resulted in resolution of the lesions confirming the diagnosis. To our knowledge, this is the second case of
oxacillin-induced cutaneous LCV described in literature.