What substance is associated with this presentation?

A 45-year-old female presents with painful lesions on her lower limbs and ears. She is a smoker, and has a history of recreational drug use. Purpuric, necrotic lesions are noted on both lower extremities, in addition to tender purpura on both ears. A biopsy is performed which demonstrates leukocytoclastic vasculitis. Use of which substance is most likely to be associated with this presentation?

A. Heroin
B. Marijuana
C. Cocaine
D. Bath Salts

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Discussion