Dear Editor, Botulinum neurotoxin injection for the treatment of facial wrinkles is nowadays more popular than surgical intervention because the procedure is much easier and shows high patient satisfaction. Interestingly, there was a generalized skin rash not only in all injection sites but also on distant parts including extremities and buttocks along with a vasculopathic reaction pattern in histopathology assessment which was interpreted as a drug reaction. To the best of our knowledge, there are a few case reports of the generalized drug eruption following botulinum toxin injection,4 and this presentation as a generalized skin eruption with vasculopathic reaction pattern in histopathology assessment has not been described before.