Lupus Erythematosus‐like Eruption due to D‐Penicillamine in Progressive Systemic Sclerosis

Abstract

A 58-year-old woman with progressive systemic sclerosis developed a butterfly erythematous erruption, hemorrhagic maculae, crusting, and erosions on the face 15 days following administration of D-penicillamine. This appeared to be a lupus erythematosus-like eruption due to an adverse drug reaction to D-penicillamine because of the rapid recovery from the general symptoms, the total involution of skin lesions with topical treatment only, the transient demonstration of autoantibodies and their fast negativation, negative ANA, and the histologic features of lupus erythematosus combined with marked exudative changes.

Drug-induced lupus erythematosus

“…Numerosi sono gli effetti collaterali. I più frequenti sono quelli cutanei, gastrointestinali, ematologici e renali; ma più raro è l'induzione di DILE (40). In quest'ultimo caso il DILE può manifestarsi in forma totalmente asintomatica con positività degli autoanticorpi ed ipocomplementemia, o con un quadro clinico severo caratterizzato da artrite o artralgie, sierosite, rash cutaneo, malessere generale e perdita di peso (41).…”

Isolation of Human Anti‐idiotypes Broadly Cross Reactive with Anti‐dsDNA Antibodies from Patients with Systemic Lupus Erythematosus

“…As SLE is considered the prototype systemic autoimmune disease, the idiotype‐anti‐idiotype (Id) profiles of its most characteristic autoantibody, anti‐dsDNA, have been studied by many investigators [5–15]. We have isolated anti‐anti‐dsDNA (anti‐Id) antibody from four SLE sera with the following precipitin profiles; one anti‐Ro/SSA and anti‐La/SSB serum, two sera with anti‐Ro/SSA alone and one with anti‐Ro/SSA and U 1 RNP precipitins.…”