Rivastigmine transdermal patches can provide non-invasive, continuous drug delivery, and offer significant potential advantages over oral treatments. However, the most common side effects of transdermal patch form is local skin reactions. A 75-years old female patient developed itching after the initiation of rivastigmine transdermal patch. Multiple, erythematous infiltrated annular plagues with significant borders (identical in shape with the patch) and generalised, excoriated erythematous papules, in addition to the lichenificated excoriated plaques on both legs were detected in her physical examination. Histopathological examination of the skin biopsy which was performed from the lesions revealed leucocytoclastic vaculitis showing spongiosis and leucocyte deposition around the vessels. She responded to topical potent steroids and systemic antihistamines and recovered completely within a month. This is the first case of rivastigmine transdermal patch induced vasculitic skin eruption which was located in both application and non-application sites.