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To the Editor.—
The May Archives (113:630-635, 1977) contains an interesting report of a case of elastosis perforans serpiginosa (EPS) induced by penicillamine. Although there have now been a number of reports of patients with EPS who have received penicillamine therapy for Wilson's disease, it is still unclear as to whether it is the drug alone that is responsible for the eruption (or perhaps some underlying predisposition in patients with Wilson's disease to effects of penicillamine).For the past few months I have been following up on the case of an individual with EPS who has extensive involvement of neck, arms, and thighs and who had been receiving penicillamine for nine years for cystinuria. This additional case of EPS associated with penicillamine therapy may add to the evidence for the etiologic significance of this drug.
Abel M. Elastosis Perforans Serpiginosa Associated With Penicillamine. Arch Dermatol. 1977;113(9):1303. doi:10.1001/archderm.1977.01640090151057