Nevirapine is the first drug of non-nucleoside reverse transcriptase inhibitors (NNRTI) class to treat seropositive patients, administered along with protease inhibitors and/or NRTIs. Nevirapine binds directly to reverse transcriptase (RT) and blocks the RNA-dependent and DNA-dependent polymerase enzyme. Exfoliative dermatitis is wide spread erythema and scaling of skin caused by pre-existing skin disorders, drugs and cancer, unknown causes. HIV infected patients are more prone to exfoliative dermatitis. This is a case report of 30 years male seropositive patient admitted in dermatology department with complaints of scaling over the skin since 9 days and had history of present illness started over the face and then extended to involve the trunk area and flexors the upper limbs and up to mid-thigh. He was taking zidovudine, lamivudine and efavirnz, but by mistakenly he was dispensed with nevirapine. The reaction started immediately after taking ZLN regimen. On the day of administration of the drug he developed itching and within 3 days scaly lesions are present over the body. He had a past history of similar complaints on intake of nevirapine. The lesions are erythematous and scaly plagues were present over the face, neck, trunk and back. The patient was diagnosed as nevirapine induced exfoliative dermatitis. De-challenge test was done and we performed ADR analysis which proved it as probable ADR.
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