Pemphigus vulgaris induced by D-penicillamine therapy in a patient with systemic sclerosis.
case_report · Level V
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Abstract
D: -Penicillamine-induced pemphigus occurs infrequently, typically in patients with rheumatoid arthritis. We describe a patient with systemic sclerosis who experienced this complication 3 months after starting D -penicillamine therapy. Nikolsky's sign, histopathologic findings, and direct immunofluorescence all confirmed the diagnosis. Termination of disease progression required intravenous pulse glucocorticoids, azathioprine, and 3 courses of plasmapheresis. The presentation, treatment, and etiology of D -penicillamine-induced pemphigus are reviewed, and the incidence of this complication in scleroderma patients is examined.
Medical subject headings
- Antirheumatic Agents
- Pemphigus
- Penicillamine
- Scleroderma, Systemic