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THE AIM: To present severe cutaneous adverse reactions caused by calcium channel blockers. INTRODUCTION: Severe skin cutaneous adverse reactions associated with the use of calcium channel blockers include acute generalized exanthematous pustulosis (AGEP), vasculitis, Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). Although, these adverse events occur rarely, they are characterized by severe clinical course, high morbidity and mortality rate, and potentially fatal outcome. The majority of these adverse events occur soon after drug administration (verapamil, diltiazem or nifedipine) affecting large body surface area. Acute generalized exanthematous pustulosis (AGEP) is characterized by sudden eruption of small, disseminated, sterile pustules, accompanied by fever and neutrophilia, usually starting on the face and spreading to the other parts of the skin. Leukocytoclastic vasculitis is characterized by symmetric disseminated erythematous or violaceous papules, most frequently localized in the lower extremities. These purpuric lesions may progress to ulcerations. Toxic epidermal necrolysis (TEN) is the most severe skin side effect, with estimated mortality up to 30%, characterized by widespread erythema, mucous membranes involvement, extensive necrotic epidermal detachment and formation of flaccid blisters. Significant necrosis and exfoliation is present, resulting in possible severe complications such as sepsis, hypovolemic shock and multi-organ failure. Toxic epidermal necrolysis is affecting over 30% of the body surface area, while Stevens- Johnson syndrome (SJS) is in a fact minor form of toxic epidermal necrolysis (TEN) limited to less than 10% of the body surface area. CONCLUSION: Considering severe skin adverse reactions cause significant morbidity and mortality, it is essential to recognize and detect symptoms in time, in order to enable immediate discontinuation of the culprit drug as well as to provide adequate supportive therapy. [ABSTRACT FROM AUTHOR]