A 23-year-old man presented with the onset of a widespread pruritic eruption 4 days after ingestion of an Ecstasy tablet for the first time. The rash was characterized by small papules up to 10 mm in diameter distributed in a guttate pattern over most of his body and displaying the Köbner phenomena. Histology diagnosed a psoriasiform drug eruption. The eruption was not responsive to the initial treatment of topical betamethasone dipropionate 0.1% ointment and oral prednisolone. Prompt resolution was achieved with narrowband UVB treatment and avoidance of rechallenge.