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Penicillamine Revisited: Historic Overview and Review of the Clinical Uses and Cutaneous Adverse Effects

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Abstract

Penicillamine is a well-known heavy metal chelator, classically used in the treatment of Wilson disease, rheumatoid arthritis, and cystinuria. From a dermatologic standpoint, penicillamine was found to be useful in the treatment of systemic sclerosis. The successful therapeutic uses of penicillamine have been hindered by its numerous adverse effects, both cutaneous and extra-cutaneous. It is a unique drug since it provokes a diversity of dermatologic manifestations that include (1) acute hypersensitivity reactions, (2) dermopathies characterized by elastic fiber abnormalities including elastosis perforans serpiginosa and pseudo-pseudoxanthoma elasticum, (3) autoimmune disorders such as pemphigus and penicillamine-induced lupus erythematosus-like syndrome, and (4) miscellaneous dermatoses that result from undefined mechanisms. These cutaneous adverse effects may correlate with the dosage and duration of penicillamine therapy as well as the disease being treated.

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Acknowledgments

No sources of funding were received to prepare this review. The authors have no conflicts of interest that are directly relevant to the content of this review.

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  1. Department of Dermatology, American University of Beirut Medical Center, Riad El Solh/Beirut, P.O. Box 11-0236, Beirut, 1107 2020, Lebanon

    Rim Ishak & Ossama Abbas

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Ishak, R., Abbas, O. Penicillamine Revisited: Historic Overview and Review of the Clinical Uses and Cutaneous Adverse Effects. Am J Clin Dermatol 14, 223–233 (2013). https://doi.org/10.1007/s40257-013-0022-z

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