Saviz Saghari, Marie Geha, Mason Arbabi, Hamayon Babary
Clopidogrel is a commonly prescribed antiplatelet agent used to prevent thrombotic events, particularly in patients with cardiovascular disease. While effective, hypersensitivity reactions, though rare, can complicate its use. We present the case of a 70-year-old male with a history of coronary artery disease who developed a progressive bilateral lower extremity rash following long-term clopidogrel use. Laboratory findings revealed elevated inflammatory markers, and a skin biopsy showed superficial perivascular lymphocytic infiltrate with rare eosinophils. The patient was diagnosed with clopidogrel-induced hypersensitivity, leading to discontinuation of the drug and initiation of ticagrelor. A short course of systemic corticosteroids and antihistamines resulted in symptom resolution within two weeks.