Pulmonary arterial hypertension is characterized by an increase in pulmonary vascular resistance. It may occur in diverse clinical settings, such as congenital heart disease, chronic lung disease, connective tissue disease, or could be idiopathic. Pulmonary arterial hypertension may cause significant morbidity and mortality. Iloprost is a stable prostacyclin analog with vasodilatory properties. To overcome its systemic side effects, the inhaled route has been used to obtain pulmonary selectivity. We herein report an unusual case of a cutaneous reaction to continuous inhaled iloprost. To our knowledge, there are scarce case reports on cutaneous side-effects of inhaled iloprost in the pediatric population. The objective of this clinical case report is to highlight this unusual reaction to avoid incorrect diagnoses and treatments.