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July 1990

Biochemical Acantholysis Provoked by Thiol Drugs

Author Affiliations

Department of Dermatology First School of Medicine, University of Naples and the Istituto Nazionale Tumori di Napoli Piazza 4 Giornate 64 80128 Naples, Italy

Arch Dermatol. 1990;126(7):965-966. doi:10.1001/archderm.1990.01670310129023

To the Editor.—  We read with interest the article by Yokel et al1 in the October 1989 issue of the Archives, dealing with the in vitro induction of acantholysis by means of penicillamine and captopril in the absence of pemphigus autoantibody. The experiments and results reported in the article are very similar to those carried out by us, first with penicillamine2 (as quoted in the article), then with captopril and thiopronine3 (Fig 1) (left unmentioned), and by others4 (also unmentioned).On the whole, these studies show that drugs containing thiol groups in their molecule (such as penicillamine, captopril, thiopronine), as well as some cyclic sulfone drugs that have a masked thiol group (eg, piroxicam), are capable of causing acantholysis without antibody mediation (biochemical acantholysis), similar to that obtained in tissue cultures added with pemphigus autoantibodies (immunological acantholysis). The proven existence of a biochemical acantholysis may well

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