Acute generalized exanthematous pustulosis (AGEP) is a rare severe pustular cutaneous eruption associated with fever and leukocytosis. Rarely, intake of lacquer chicken can induce AGEP. Case History: We described two cases of AGEP developed after ingestion of lacquer chicken, which showed a positive patch test and were accompanied by unusual clinical manifestations. Results: One 45-year-old man presented with fever, blood leukocytosis with neutrophilia, maculopapular skin rash and pustular formation, which developed after eating lacquer chicken. Severe hypotension and later elevated hepatic enzymes were accompanied. Patch test to undiluted lacquer was positive. The other 48-year-old man was admitted with fever, maculopapular skin rash and subsequent pustular formation and blood leukocytosis with neutrophilia following ingestion of lacquer chicken. One week later, blood eosinophilia and elevated liver enzymes were found. Conclusion: AGEP may be caused by ingestion of lacquer chicken via Type IV immune hypersensitivity and can be accompanied by hypotension, blood eosinophilia and/or abnormal hepatic function.