BW/day). 8 In TEN, cessation of the causing agent, high-dose intravenous immunoglobulins together with systemic steroids are recommended. 9 The prognosis of both conditions is generally very poor: in our patient the severity-of-illness score for TEN (SCORTEN) was 4, predicting a mortality rate of 58.3%. 4,9 In acute grade IV, cutaneous GvHD long term survival (>5 years) is only 5%. 10 We report a TEN-like acute cutaneous GvHD in a stem cell recipient, which caused a diagnostic dilemma as clinical and histopathological findings of TEN and GVHD are overlapping. As therapeutic recommendations differ between these two lifethreatening conditions, a distinction of cutaneous GvHD and TEN is very important. In our case, the presence of painless skin lesions, the distribution and evolvement of the exanthema led us favour the diagnosis of cutaneous GvHD.