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Nail-changes induced by penicillamine.

M Bjellerup1

  • 1Department of Dermatology, University of Lund, General Hospital, Malmö, Sweden.

Acta Dermato-Venereologica
|January 1, 1989
PubMed
Summary
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Penicillamine treatment for rheumatoid arthritis can cause unusual nail changes, including loss of lunulae and nail defects. These nail abnormalities resolved after stopping the drug and recurred upon reintroduction.

Area of Science:

  • Rheumatology
  • Dermatology
  • Pharmacology

Background:

  • Rheumatoid arthritis is a chronic autoimmune disease.
  • Penicillamine is a disease-modifying antirheumatic drug (DMARD) used in rheumatoid arthritis treatment.
  • Drug-induced side effects are a significant concern in managing chronic conditions.

Observation:

  • A 70-year-old woman with rheumatoid arthritis developed peculiar nail changes after one year of penicillamine therapy.
  • Observed changes included absence of lunulae, longitudinal ridging, nail plate defects, and onychoschizia.
  • Fingernails were more severely affected than toenails.

Findings:

  • Discontinuation of penicillamine led to gradual nail resolution over seven months.
  • Reintroduction of penicillamine caused a recurrence of the nail changes.

Related Experiment Videos

  • A causal relationship between penicillamine and the observed nail pathology was established.

    • Implications:

    • Penicillamine can induce specific nail abnormalities.
    • Monitoring for nail changes is important during penicillamine treatment for rheumatoid arthritis.
    • Understanding drug-induced nail changes aids in differential diagnosis and patient management.