The photo above is a pretty classic case of vasculitis, with palpable purpura, and these lesions HURT. The patient is a young healthy school teacher and we never found the cause.
This is a leukocytoclastic vasculitis, too. This patient, who has a lot of medical problems including a diabetic foot ulcer, went to an emergency room with this painful rash and they told her it was an allergy. I did a biopsy which confirmed the diagnosis.
The list of things that can trigger vasculitis is LONG, and sometimes you don’t figure it out, but don’t miss this.