A 50-year-old woman presented with a 3-day history of a progressive, painful, non-blanchable, purpuric rash (retiform purpura) with areas of necrosis and bullae formation involving her face, trunk, extremities, and oral and nasal mucosa (Figure 1). She endorsed a history of cocaine use, and urine toxicology screening was positive for both cocaine and levamisole by liquid chromatography-tandem mass spectrometry. Laboratory findings included leukopenia and …