Paraneoplastic cutaneous small-vessel vasculitis as a presentation of recurrent metastatic breast cancer

Cutaneous small-vessel vasculitis (CSVV) is a vasculitis of small vessels that classically presents with purpuric papules on the lower extremities. It may occur in the setting of several triggers such as infection, drug exposure, and collagen vascular disease.1 Of all cases of CSVV, fewer than 5% are thought to be paraneoplastic.2 Most of these cases are associated with hematologic malignancies (90%), whereas the remainder are associated with solid organ malignancies (10%).3 We present a rare case of paraneoplastic CSVV that specifically occurred in the setting of recurrent metastatic breast cancer.