Rifampicin induced purpura of left lower limb: Illustrative medical image

Rifampicin-induced purpura is a rare hypersensitivity reaction encountered during anti tubercular therapy (ATT). We report a 43-year-old male with cervical tubercular lymphadenitis who developed purpuric lesions with distinctive orange-colored serous discharge over the left lower limb after initiation of ATT. Investigations excluded thrombocytopenia and systemic vasculitis. A temporal relationship between drug intake and symptom onset confirmed rifampicin as the causative agent. Prompt withdrawal of rifampicin and initiation of systemic corticosteroids led to complete resolution of the lesions. This case highlights the need for vigilance regarding rare dermatological adverse effects in patients on ATT and the importance of prompt clinical recognition to prevent serious complications.