and exfoliative dermatitis (including toxic epidermal necrolysis ). In addition, a rare, distinct entity with clinical and laboratory features indistinguishable from those of subacute cutaneous lupus erythematosus has been associated with HCTZ. A 67-year-old white woman with hypothyroidism, hypercalcemia, depression, and hypertension developed facial erythema , headaches , tremors , confusion ,