Gabapentin-Induced Cutaneous Leukocytoclastic Vasculitis: A Case Report

Area of Science:

• Dermatology
• Pharmacology
• Pathology

Background:

• Leukocytoclastic vasculitis (LCV) is a small vessel vasculitis often idiopathic, but commonly triggered by infections or drugs.
• Cutaneous manifestations of drug reactions require vigilant diagnosis and management.

Observation:

• An 88-year-old woman presented with an erythematous maculopapular rash on her thighs three days after initiating gabapentin for neuropathic pain.
• Skin biopsy confirmed cutaneous vasculitis with a leukocytoclastic pattern.

Findings:

• The patient's rash resolved within 10 days of discontinuing gabapentin, strongly suggesting a drug-induced etiology.
• This case represents one of only a few documented instances of LCV secondary to gabapentin use.

Implications:

• This case underscores the importance of considering drug-induced cutaneous vasculitis, even with commonly prescribed medications like gabapentin.
• Early recognition and withdrawal of the offending agent are critical for managing drug-related LCV and preventing severe complications.