Combined features of pemphigus and pemphigoid induced by penicillamine

D-Penicillamine is able to induce a bullous eruption with the clinical, histological and immunological features of pemphigus. We present a case that had all the characteristics of pemphigus, but also in vivo bound IgG against the dermo-epidermal junction, i.e. the immunological features of bullous pemphigoid. Since no subepidermal blistering was observed, it is concluded that the penicillamine-induced auto-antibodies against the basement membrane zone were biologically inactive.