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Pseudoxanthoma-elasticum-like skin changes induced by penicillamine
1Department of Dermatology, Yale University School of Medicine, New Haven, CT 06510.
Dermatology (Basel, Switzerland)
|January 1, 1992
Summary
Penicillamine therapy can cause skin issues like wrinkling and fragility by affecting collagen and elastin. A patient with cystinuria developed pseudoxanthoma-elasticum-like skin lesions due to long-term penicillamine use.
Area of Science:
- Dermatology
- Pharmacology
- Connective Tissue Biology
Background:
- Penicillamine is a chelating agent used to treat Wilson's disease and cystinuria.
- It interferes with collagen and elastin cross-linking, potentially causing skin abnormalities.
- These side effects are typically observed in patients undergoing long-term penicillamine therapy.
Observation:
- A case report details a patient with cystinuria on long-term, high-dose penicillamine.
- The patient presented with pseudoxanthoma elasticum-like skin lesions, including yellow papules and redundant skin folds.
- Lesions were observed in the axillae, neck, anterior axillary line, and lower buttocks.
Findings:
- Histological examination revealed 'lumpy-bumpy' dermal elastic fibers in both affected and unaffected skin.
- No calcium deposition was observed in the dermal elastic fibers.
- The observed histological changes resemble previously documented penicillamine-induced skin lesions.
Implications:
- This case highlights the potential for penicillamine to induce pseudoxanthoma elasticum-like changes.
- Understanding these drug-induced skin manifestations is crucial for managing patients on long-term penicillamine therapy.
- Further research may elucidate the precise mechanisms of penicillamine's effects on dermal elastic fibers.