Letrozole induced Necrotizing Cutaneous Vasculitis: A Rare Entity

Cutaneous small vessel vasculitis (CSVV) could be due to varied etiologies of which drug induced CSVV is a prime cause. It commonly presents as purpura but necrotizing lesions can be an uncommon presentation of the disease. Aromatase inhibitors like letrozole are newer drugs used in the management of breast carcinoma. There have been few reports of drug induced vasculitis secondary to letrozole. Herein, we report a case presenting with multiple purpura with ulcers and hemopurulent discharge over bilateral legs after letrozole intake for breast carcinoma. Patient was diagnosed with necrotizing CSVV due to letrozole based on history and clinico-histopathological correlation. To the best of our knowledge, this is the first report of letrozole induced necrotizing CSVV from India.