Late Onset Leflunomide-Induced Cutaneous Ulcers in a Seronegative Arthritis Patient: A Case Report

A 67-year-old woman with seronegative arthritis developed multiple chronic cutaneous ulcers that did not respond to conventional treatments. After extensive testing ruled out common causes, it was determined that the ulcers were induced by leflunomide, a medication she had been taking for 12 years. Discontinuing leflunomide resulted in the resolution of the ulcers. This case represented the longest reported duration between the start of leflunomide treatment and the onset of ulceration.