Pemphigus vulgaris induced by D-penicillamine therapy in a patient with systemic sclerosis.
D: -Penicillamine-induced pemphigus occurs infrequently, typically in patients with rheumatoid arthritis. We describe a patient with systemic sclerosis who experienced this complication 3 months after starting D -penicillamine therapy. Nikolsky's sign, histopathologic findings, and direct immunofluorescence all confirmed the diagnosis. Termination of disease progression required intravenous pulse glucocorticoids, azathioprine, and 3 courses of plasmapheresis. The presentation, treatment, and etiology of D -penicillamine-induced pemphigus are reviewed, and the incidence of this complication in scleroderma patients is examined.
Shapiro
M
M
Department of Medicine, Pennsylvania Hospital, Philadelphia, USA.
Jimenez
S
S
Werth
V P
VP
D000368:Aged; D018501:Antirheumatic Agents / Q000009:adverse effects*; D018450:Disease Progression; D005260:Female; D006801:Humans; D010392:Pemphigus / Q000139:chemically induced* / Q000473:pathology; D010396:Penicillamine / Q000009:adverse effects*; D012595:Scleroderma, Systemic / Q000188:drug therapy*
D018501:Antirheumatic Agents; D010396:Penicillamine