Leflunomide is a new oral drug licensed for the treatment of rheumatoid arthritis and psoriatic arthritis. Common adverse events reported include gastrointestinal symptoms, reversible alopecia, hypertension and transient alteration in liver function tests. Severe cutaneous drug reactions have been reported recently with its increased clinical used such as vasculitis, erythema multiforme, toxic epidermal necrolysis (1) and drug hypersensitivity syndrome (2). We report a case of photodistributed eruption with rhabdomyolysis due to leflunomide.This patient was a 60-year-old woman, with a 19-year history of rheumatoid arthritis and Sjogren's syndrome. She was previously treated with gold salts, hydroxychloroquine and salazopyrine. Leflunomide (10mg/day) and prednisone (18mg/day) were started in December 2008 after a methotrexate-induced leucopenia. Other laboratory findings revealed positive rheumatoid factor and a high titre (1/2560) of antinuclear antibodies. Anti-DNA and anti-extractable nuclear antigen (ENA; anti-SSA and anti-SSB) antibodies were positive.
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