Sepsis-Inducing Leukocytoclastic Vasculitis Resistant to Steroid Therapy: A Case Report

A 34-year-old White male presented with a persistent rash on the lower extremities characterized by erythema, liquid drainage, and severe burning pain. Initially misattributed to contact dermatitis, the condition worsened despite treatment with prednisone and doxycycline. Leukocytoclastic vasculitis (LCV) was confirmed via punch biopsy. The patient's treatment involved conservative measures, systemic prednisone therapy, doxycycline, and later adjunctive dapsone. Nevertheless, the patient developed secondary bacterial infection with methicillin-sensitive <i>Staphylococcus aureus</i> and <i>Pseudomonas aeruginosa</i>. This case highlights an uncommon presentation of idiopathic LCV that led to sepsis and reviews management for persistent vasculitis.