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The elderly segment of our population continues to grow. Along with this growth in population is a growth in incidence of cardiovascular disease, the metabolic syndrome, chronic kidney disease, cerebrovascular disease, and diabetes mellitus. There is no known panacea for managing these chronic disease conditions; however, lipid-lowering therapy has been shown to prevent or delay the progression of these diseases and the mortality and morbidity that accompanies them.

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Hepatitis C virus (HCV) infection has been associated with various dermatological manifestations. 1 Pruritus, porphyria cutanea tarda, lichen planus, vitiligo, vasculitis, cryoglobulinemia, urticaria and erythema multiforme are cited. 2 Health-care providers should screen patients with these conditions for HCV infection. Palpable purpura, urticaria or livedo reticularis, frequently present as leukocytoclastic vasculitis with mixed cryoglobulinemia (MC). 3 However, rarely HCV-related cutaneous vasculitis may not be due to MC and resembles polyarteritis nodosa. 4 We report a case of cutaneous vasculitis without detectable cryoglobulinemia in a patient with chronic HCV infection.A 49-year-old woman with chronic HCV infection had increased levels of aminotransferases for more than 6 months, HCV viremia by polymerase chain reaction (PCR), genotype 1a and a liver biopsy with chronic hepatitis activity (grade 2 of 4) with minimal fibrosis (stage 1 of 4). She was treated with a-interferon (IFN-a) and ribavirin for 12 months. Her PCR-HCV became negative at the end of treatment, but relapse after 6 months. One year later, she presented palpable purpura and pruritus on the lower extremities and a skin biopsy showed leukocytoclastic vasculitis (Fig. 1).Laboratory findings showed normal hematocrit, leukocyte and platelets count, serum protein, urinalysis, and serum creatinine levels, thyroid-stimulating hormone, a-1 antitrypsin, a-fetoprotein and ceruloplasmin. All autoantibodies were negative. Cryoglobulins were not detected in two consecutive samples taken

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