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The authors present a case of a 54-year-old male who presented to the ED with Stevens Johnson syndrome (SJS) beginning on his upper lips, then spreading to his glans penis, airway, and buttocks. After using trimethoprim-sulfamethoxazole (TMP-SMX) to treat a pilonidal cyst diagnosed seven days prior to presentation, the patient began to have desquamating lesions on his upper and lower lips. Subsequently, he noticed desquamation on the glans penis and then between his buttocks. Before being referred to dermatology, he was treated with a high dosage of corticosteroids.

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