A 41-year-old man, who was diagnosed as having human immunodeficiency virus (HIV) infection 2 weeks previously, presented to the San Francisco General Hospital emergency department, San Francisco, Calif, with acute generalized exanthematous pustulosis. The patient had begun antiretroviral therapy (ART) with stavudine, didanosine, and nelfinavir mesylate 10 days prior to presentation. His CD4 cell count was 501/µL, with a viral load of 20 copies/mL. He was admitted to the inpatient service for management. His cutaneous eruption resolved with discontinuation of all antiretroviral medications. The patient received a 10-day course of oral prednisone at 60 mg/d, which was then tapered to 30 mg/d for an additional 10 days.