Lupus erythematosus-like eruption due to D-penicillamine in progressive systemic sclerosis

A 58-year-old woman with progressive systemic sclerosis developed a butterfly erythematous eruption, hemorrhagic maculae, crusting, and erosions on the face 15 days following administration of D-penicillamine. This appeared to be a lupus erythematosus-like eruption due to an adverse drug reaction to D-penicillamine because of the rapid recovery from the general symptoms, the total involution of skin lesions with topical treatment only, the transient demonstration of autoantibodies and their fast negativation, negative ANA, and the histologic features of lupus erythematosus combined with marked exudative changes.