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Epidermolysis bullosa acquisita–like reaction associated with penicillamine therapy for sclerodermatous graft-versus-host disease

2003; Elsevier BV; Volume: 49; Issue: 6 Linguagem: Inglês

10.1016/s0190-9622(03)00441-9

1097-6787

Petra Cetkovská, Karel Pizinger, Alena Skálová,

Autoimmune Bullous Skin Diseases

A case of a bullous eruption occurred in a patient being treated with penicillamine for sclerodermatous graft-versus-host disease following bone marrow transplantation. After 7 days of treatment with 150 mg penicillamine, a painful bullous eruption with accompanying purpuric lesions suddenly developed in previous sclerodermatous infiltrations. A diagnosis of epidermolysis bullosa acquisita–like eruption was made, and the patient was treated with drug withdrawal and administration of cyclosporine and methylprednisolone. Epidermolysis bullosa acquisita–like reaction is an extremely rare cutaneous side effect of penicillamine. The surprisingly early onset of this eruption in lesions of sclerodermatous graft-versus-host disease might have been due to severe immune alteration.