Apixaban-Induced Leukocytoclastic Vasculitis: An Uncommon Complication of a Common Anticoagulant

Apixaban-induced leukocytoclastic vasculitis (LCV) is rare, with only a handful of cases reported. We describe a 68-year-old man who developed a diffuse, painful, pruritic rash and myalgias approximately six weeks after the initiation of apixaban. Extensive infectious and autoimmune workups were negative. Although the skin biopsy was nonspecific, corticosteroid therapy and apixaban discontinuation led to marked clinical improvement. The temporal association and exclusion of other causes support apixaban as the likely trigger. This case contributes to the growing recognition of apixaban-induced LCV and highlights the need to consider drug-induced etiologies in new-onset vasculitic rashes, especially in anticoagulated patients.