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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

See the image, find the answer, discuss this case, and more on Figure 1.

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