title: Herpetiform pemphigus induced by penicillamine.
abstract: A patient with arthritis is described who developed a dermatitis herpetiformis-like rash after 8 months of D-penicillamine therapy and which cleared soon after the drug was discontinued. The histopathological findings were compatible with a diagnosis of pemphigus, showing intra-epidermal vesicles and spongiosis but no acantholysis. Intercellular antibody was detected by indirect immunofluorescence at the onset of the eruption (titre 1 in 160) and also found in serum taken prior to penicillamine treatment (titre 1 in 20). It is now well known that D-penicillamine can induce pemphigus. The findings reported here suggest the possibility that the patient was predisposed to develop the eruption before the drug was given.
mesh_terms: D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D003874:Dermatitis Herpetiformis / Q000175:diagnosis; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008875:Middle Aged; D010392:Pemphigus / Q000139:chemically induced* / Q000175:diagnosis; D010396:Penicillamine / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D010396:Penicillamine