Capecitabine-Induced Leukocytoclastic Vasculitis in a Patient with Colorectal Cancer: A Case Report

Background Leukocytoclastic vasculitis (LCV) is an uncommon cutaneous adverse event that may occur in association with chemotherapy. Although capecitabine is widely prescribed for colorectal cancer, LCV remains an exceptionally rare complication, with only a few cases reported in the literature. Case Report: We present the case of a 67-year-old man with stage III colorectal adenocarcinoma who underwent curative resection. His past medical history included hypertension and type 2 diabetes mellitus, rendering him unsuitable for oxaliplatin-based chemotherapy; he was therefore initiated on adjuvant capecitabine monotherapy. After the third cycle, he developed a purpuric rash predominantly affecting the lower extremities. Clinical examination revealed multiple palpable purpura without systemic involvement. Laboratory investigations—including complete blood count, autoimmune markers, complement levels, cryoglobulins, and viral serologies—were unremarkable. Based on the temporal relationship with treatment initiation and exclusion of alternative causes, a diagnosis of capecitabine-induced LCV was established. Capecitabine was discontinued, and corticosteroid therapy led to progressive resolution of the lesions. Conclusion Capecitabine-induced LCV is a rare but clinically significant adverse event. Oncologists should maintain a high index of suspicion for this entity when evaluating new-onset purpura in patients receiving chemotherapy. Prompt recognition and discontinuation of the causative drug are crucial to prevent unnecessary investigations and ensure appropriate management.