| CASE REPORT |
|
| Year : 2011 | Volume
: 77
| Issue : 1 | Page : 55--58 |
Penicillamine-induced elastosis perforans serpiginosa with abnormal "lumpy-bumpy" elastic fibers in lesional and non-lesional skin
Swapna S Khatu, Rachita S Dhurat, Chitra S Nayak, Rickson R Pereira, Rucha B Kagne
Department of Dermatology, T.N. Medical College and B.Y.L. Nair Ch. Hospital, Mumbai Central, Mumbai - 400 008, India
Correspondence Address:
Rachita S Dhurat
B 14/2, Maitri Park Co. Op. Hsg. Soc. Sion Trombay Road, Chembur, Mumbai - 400 071
India
DOI: 10.4103/0378-6323.74982 PMID: 21220881
Four types of elastosis perforans serpiginosa (EPS) have been described in literature: 1) idiopathic EPS, 2) reactive perforating elastosis associated with connective tissue disorders, 3) in some instances of pseudoxanthoma elasticum (PXE), disease-specific calcified elastic tissue is extruded, producing a clinical picture indistinguishable from other types, may also be seen in patients undergoing hemodialysis and 4) EPS induced by long-term treatment with D-penicillamine is observed in patients suffering from Wilson's disease. Long term D-penicillamine therapy causes an alteration in the dermal elastic tissue. D-penicillamine induced EPS has a distinctive histopathologic feature - serrated appearance of elastic fibers due to perpendicular budding from their surface giving a "lumpy-bumpy" look. D-penicillamine induced elastic fiber alteration may not always manifest clinically as EPS. We report a case of D-penicillamine induced widespread alteration in skin elastic tissue with distinct histopathologic features.
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