Epidermolysis bullosa acquisita-like reaction associated with penicillamine therapy for sclerodermatous graft-versus-host disease.
A case of a bullous eruption occurred in a patient being treated with penicillamine for sclerodermatous graft-versus-host disease following bone marrow transplantation. After 7 days of treatment with 150 mg penicillamine, a painful bullous eruption with accompanying purpuric lesions suddenly developed in previous sclerodermatous infiltrations. A diagnosis of epidermolysis bullosa acquisita-like eruption was made, and the patient was treated with drug withdrawal and administration of cyclosporine and methylprednisolone. Epidermolysis bullosa acquisita-like reaction is an extremely rare cutaneous side effect of penicillamine. The surprisingly early onset of this eruption in lesions of sclerodermatous graft-versus-host disease might have been due to severe immune alteration.
Cetkovská
Petra
P
Department of Dermatology, Charles University Hospital, Dr. E. Benese 13, 305 99 Pilsen, Czech Republic. cetkovska@fnplzen.cz
Pizinger
Karel
K
Skálová
Alena
A
D016026:Bone Marrow Transplantation / Q000009:adverse effects; D016572:Cyclosporine / Q000627:therapeutic use; D016107:Epidermolysis Bullosa Acquisita / Q000139:chemically induced*; D006086:Graft vs Host Disease / Q000188:drug therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D010396:Penicillamine / Q000009:adverse effects*; D012595:Scleroderma, Systemic / Q000188:drug therapy
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D010396:Penicillamine; D008775:Methylprednisolone