Leflunomide-Induced Cutaneous Ulcers: A Rare Diagnostic Conundrum

A 66-year-old woman with rheumatoid arthritis developed non-healing cutaneous ulcers after starting leflunomide, a medication used to treat her condition. Despite treatment with antibiotics and steroids, the ulcers worsened until leflunomide was discontinued, leading to significant healing within 2 weeks. The case highlights the potential for leflunomide to cause skin ulceration, particularly when combined with methotrexate, due to their synergistic effects on cell metabolism. The study emphasizes the importance of early recognition and discontinuation of leflunomide to prevent severe adverse effects.