Leukocytoclastic Vasculitis: Distinguishing Drug-Induced From Hepatitis C-Related Causes

This report presents the case of a 34-year-old female with chronic cholecystitis and hepatic failure due to alcohol use and hepatitis C. She also has a history of opioid and alcohol use disorders. Frequent hospitalizations for fluid overload culminated in her presentation with lower extremity swelling and palpable purpura. Investigation revealed leukocytoclastic vasculitis, initially raising concern for mixed cryoglobulinemia from hepatitis C but ultimately more likely due to drug-induced vasculitis. This case highlights the diagnostic challenge of differentiating between hepatitis C-associated mixed cryoglobulinemia and drug-induced vasculitis, emphasizing the need for thorough evaluation to guide appropriate management.