Erythema elevatum diutinum – An atypical case presentation exposing the histopathological progression of disease

Erythema elevatum diutinum is a distinct and rare form of chronic, recurrent leukocytoclastic vasculitis that typically presents with firm, smooth erythematous to violaceous papules or nodules symmetrically distributed over the extensor surfaces. Herein, we report an unusual case of erythema elevatum diutinum in a 32-year-old female who presented with a several-year history of chronic recurrent palpable purpura prior to the development of classic nodular lesions. This presentation facilitated a timely diagnosis and highlighted the histopathologic progression of the disease broadening the clinical spectrum of erythema elevatum diutinum.