title: Decline of anti-desmoglein 1 IgG ELISA scores by withdrawal of D-penicillamine in drug-induced pemphigus foliaceus.
abstract: A case of pemphigus foliaceus arising during the administration of D-penicillamine was reported. A 72-year-old woman with systemic sclerosis developed flaccid vesicles and crusted erythema of the skin after administration of D-penicillamine for 1-year. She was positive for anti-desmoglein 1 IgG by ELISA. The withdrawal of D-penicillamine resulted in improvement of the skin lesions and ELISA scores for anti-demoglein 1 antibodies revealed a surprisingly rapid decline. This case is a classical incidence of drug-induced pemphigus foliaceus, in which D-penicillamine was constantly required not only to induce, but also to maintain the production of the autoantibodies.
authors.affiliation: Keio University School of Medicine, Department of Dermatology, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan. nagao18@sc.itc.keio.ac.jp
authors.forename: K
authors.initials: K
authors.lastname: Nagao
authors.forename: A
authors.initials: A
authors.lastname: Tanikawa
authors.forename: N
authors.initials: N
authors.lastname: Yamamoto
authors.forename: M
authors.initials: M
authors.lastname: Amagai
mesh_terms: D000368:Aged; D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001323:Autoantibodies / Q000032:analysis*; D015820:Cadherins / Q000276:immunology*; D051183:Desmoglein 1; D003875:Drug Eruptions / Q000209:etiology* / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D010392:Pemphigus / Q000139:chemically induced* / Q000276:immunology; D010396:Penicillamine / Q000008:administration & dosage / Q000009:adverse effects*; D012598:Sclerosis / Q000188:drug therapy
chemical_list: D018501:Antirheumatic Agents; D001323:Autoantibodies; D015820:Cadherins; D051183:Desmoglein 1; D010396:Penicillamine