Skin Deep: A Narrative Case Series and Review of Cutaneous Vasculitis and the Doppelgängers

Summary: Cutaneous vasculitis may present with a wide variety of lesions. These may occur in multi-systemic vasculitis, represent isolated cutaneous vasculitis, or signal mimickers arising from non-rheumatologic etiologies. ​ ​ Unwitting consumption of adulterants in recreational drugs may cause a drug-induced vasculitis or have vasoactive properties Clinicians should always consider drug-induced vasculitis, vasculitis secondary to an underlying rheumatologic disease, infectious, paraneoplastic, and vasculopathic etiologies. Objective studies should always include a skin biopsy with direct immunofluorescence.​ ​ Vasculitis of the superficial cutaneous plexus yields petechiae, purpura, papules, and persistent urticaria, whereas arteriole and venule involvement produces nodules, erosions, ulcers, or livedo. Necrosis or eschar can occur with superficial and deeper vessel involvement with prolonged disease activity. The lower extremities is the most common area of cutaneous vasculitis to present.