Omeprazole is a potent proton pump inhibitor and usually is well tolerated. Adverse effects of this drug have been reported in up to 5% of patients, most of which are trivial and disappear rapidly on discontinuation of the drug. Skin adverse reactions attributed to omeprazole are uncommon and include rashes, urticaria, angio-oedema, acute disseminated epidermal necrolysis, lichen spinulosus, and contact dermatitis. Cutaneous leucocytoclastic vasculitis (CLV) has not been previously reported in association with omeprazole. The development of CLV in an elderly patient four weeks after starting treatment with omeprazole is described.