Leukocytoclastic Vasculitis Masquerading as Chronic Idiopathic Thrombocytopenic Purpura

BACKGROUND: Idiopathic thrombocytopenic purpura and leukocytoclastic vasculitis can present in a similar fashion and can be very hard to differentiate clinically without a biopsy. This can cause diagnostic dilemma and delay in management. A thorough evaluation is recommended to determine etiology, although about half are idiopathic. CASE PRESENTATION: A patient aged 79 years with longstanding thrombocytopenia secondary to chronic idiopathic thrombocytopenic purpura presented with a rash. Although it was thought to be secondary to idiopathic thrombocytopenic purpura, a biopsy revealed presence of leukocytoclastic vasculitis. CONCLUSIONS: Although most leukocytoclastic vasculitis cases are mild and resolve without intervention, many go undiagnosed due to biopsy delays. Health care professionals should determine and treat the underlying cause.