• adverse events
• tuberculosis

Rifampicin is a bactericidal drug extensively used for tuberculosis and leprosy. Common adverse drug reactions of rifampicin are hepatotoxicity, flu-like syndrome, gastrointestinal symptoms and thrombocytopenia; cutaneous adverse reaction encountered in only ∼1.23% of cases.1

A 45-year-old man, recently diagnosed with sputum-positive pulmonary tuberculosis and started on continuation phase therapy with isoniazid and rifampicin (Cat 1) for preceding 1 month presented with 2-week history of acute onset, pruritic generalised skin eruptions. Physical examination revealed multiple, violaceous, discrete and coalescing papules and plaques distributed almost symmetrically over the scalp, face, trunk and extremities (figure 1A,B). Other mucocutaneous and systemic examination was unremarkable. Laboratory investigation was notable for peripheral eosinophilia (absolute eosinophil count 3.01 × 10ˆ9/L). Histopathological examination from lesion revealed hyperkeratosis with focal parakeratosis, basal cell degeneration with upper dermal band-like …