A patient is described with the characteristic features of phenytoin hypersensitivity syndrome (PHS) including fever, erythroderma, tibial and facial oedema, pinhead-sized facial pustules and abnormal liver function tests. The use of systemic corticosteroids in this condition is not established. We report the resolution of all the features of PHS with systemic corticosteroids and recurrence on withdrawal, and further remission on reinstitution of systemic corticosteroids.