Allergic granulomatous vasculitis, or Churg-Strauss syndrome, is a small-vessel, multisystem vasculitis that can affect the skin, lungs, heart, and nervous system. Recent reports have implicated leukotriene receptor antagonists and inhaled corticosteroids in the development of this rare syndrome. We present a patient with no history of allergic asthma who acutely developed skin-limited Churg-Strauss-like granulomatous vasculitis after initiating therapy with inhaled fluticasone and salmeterol (Advair Diskus).