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[D-penicillamine-induced pemphigus]

B Chouvet, J Thivolet, J Bathias

    Dermatologica
    |January 1, 1980
    PubMed
    Summary
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    D-penicillamine can induce pemphigus, a blistering skin condition, even after drug withdrawal. This case highlights the importance of recognizing drug-induced autoimmune diseases in patients with rheumatoid polyarthritis.

    Area of Science:

    • Dermatology
    • Rheumatology
    • Immunology

    Background:

    • Rheumatoid polyarthritis is a chronic autoimmune disease.
    • Drug-induced pemphigus is a rare but serious adverse reaction.
    • D-penicillamine is a medication used to treat rheumatoid arthritis and other conditions.

    Observation:

    • A patient with rheumatoid polyarthritis developed D-penicillamine-induced pemphigus.
    • The condition presented in two phases, with a recurrence 7 months after drug withdrawal.
    • Clinical and histopathological features were consistent with pemphigus vulgaris.

    Findings:

    • Intercellular antisubstance antibodies were detected in the patient's serum and skin.
    • The disease course required significant corticosteroid therapy, similar to classical pemphigus.

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  • Literature review identified other drug-induced pemphigus cases, including those linked to pyritinol, rifampicin, and practolol.

    • Implications:

    • This case underscores the potential for D-penicillamine to trigger autoimmune blistering diseases.
    • Awareness of drug-induced pemphigus is crucial for managing patients with rheumatoid polyarthritis on D-penicillamine.
    • Further research into the pathogenesis of drug-induced pemphigus is warranted.