A case of penicillamine-induced dermopathy.
BACKGROUND
We describe an interesting patient with penicillamine-induced dermopathy.


METHODS
A 49-year-old woman presented with a 1-year history of recurrent haemorrhagic blisters, milia and purpura over both her elbows, while on long-term penicillamine therapy (1.5 g daily) for Wilson's disease. Histologically, dermal elastin fibres were markedly reduced in the affected areas, consistent with penicillamine-induced elastolysis.


RESULTS
The patient's lesions improved significantly after reduction of her penicillamine dose to 500 mg daily.


CONCLUSIONS
The cutaneous side effects of long-term penicillamine therapy are important to recognise as they may be associated with significant morbidity and may be markers of more ominous underlying systemic elastic fibre damage.
Tang
M B
MB
National Skin Centre, 1 Mandalay Road, Singapore 308205. marktang@nsc.gov.sg
Chin
T M
TM
Yap
C K
CK
Ng
S K
SK
D001707:Biopsy, Needle; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006527:Hepatolenticular Degeneration / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D007150:Immunohistochemistry; D008134:Long-Term Care; D008875:Middle Aged; D010396:Penicillamine / Q000009:adverse effects* / Q000627:therapeutic use; D018570:Risk Assessment; D012720:Severity of Illness Index; D012872:Skin Diseases, Vesiculobullous / Q000139:chemically induced* / Q000503:physiopathology
D010396:Penicillamine