Lichen planus-like lesions caused by penicillamine in primary biliary cirrhosis

Six patients with primary biliary cirrhosis experienced lichen planus-like lesions while taking penicillamine. Oral lesions developed in all patients, and the lichenoid lesions also appeared elsewhere in two patients. Lichen planus-like lesions developed from four to 16 months after penicillamine therapy had been started, and, in four cases, they resolved in one to three months after use of the drug was stopped. Two patients have continued using penicillamine despite adverse cutaneous and mucosal reactions and have continued to experience lichen planus-like lesions intermittently. Other cutaneous reactions associated with penicillamine are reviewed.