Introduction: We describe an interesting patient with penicillamine-induced dermopathy.Clinical Picture: 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.Treatment and Outcome: 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.
D-penicillamine is a copper chelator used primarily in Wilson’s disease and cystinuria. Other long-term indications include rheumatoid arthritis, scleroderma and primary biliary cirrhosis.
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