Immunohistochemical findings in a patient with penicillamine pemphigus

This report describes the immunofluorescence (IF) findings in sequential skin biopsies and serum obtained during a follow-up study of a patient who developed pemphigus lesions after D-penicillamine treatment of arthritis. The distribution in the skin of IgG, IgM and C3 varied with the date, type and site of the biopsy sample. Thus IF patterns showed features of (a) pemphigus vulgaris, (b) pemphigus foliaceus and (c) pemphigus erythematosus. Indirect IF examination indicated the presence of circulating intercellular epithelial antibody of both the IgG and IgM class.