A man in his 70s presented to the hospital with dark urine in the setting of increased acetaminophen use. Hours after receiving a computed tomography scan with iodine-based contrast, he developed a pruritic rash. A physical examination revealed scleral icterus, jaundice, and well-circumscribed, bright yellow papules and plaques on his lateral abdomen (Figure). Laboratory findings included an alkaline phosphatase level of 903 U/L (to convert to μkat/L, multiply by 0.0167), total bilirubin level of 13.3 mg/dL (to convert to μmol/L, multiply by 17.104), direct bilirubin level of 11.6 mg/dL, alanine transaminase level of 124 U/L, and aspartate transaminase level of 145 U/L. A biopsy of the liver revealed findings consistent with drug-induced liver injury. His rash responded to treatment with antihistamines, and his transaminase levels improved with cessation of acetaminophen use.