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A: Initial presentation of recurrent painful petechiae and palpable purpura (arrow) suggestive of resistant vasculitis in a patient with vasculitis treated with cyclophosphamide; B: Worsening and progression of painful palpable purpura (arrowhead) to nodular ecchymosis after initiation of rituximab therapy. (Photographs: Wilmer L. Sibbitt, Jr.)
