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An 18-year follow-up of a case of D-penicillamine-induced Elastosis perforans serpiginosa.
[cystinuria]
Elastosis
perforans
serpiginosa
(
EPS
)
is
a
rare
complication
of
chronic
therapy
with
a
high
-dose
of
D-
penicillamine
(
1
g
daily
for
more
than
5
years
)
,
characterized
by
the
elimination
of
abnormal
elastic
fibers
from
the
upper
dermis
through
the
epidermis
.
D-
penicillamine
(
DPA
)
is
a
heavy
metal
chelator
primarily
used
for
disorders
such
as
cystinuria
and
Wilson
disease
.
This
therapy
can
lead
to
induction
of
EPS
through
a
still
unknown
mechanism
.
We
report
the
follow-up
of
a
D-
penicillamine-induced
EPS
in
patient
with
Wilson
disease
,
which
prompted
us
to
switch
the
therapy
with
trientine
(
another
metal
chelator
)
.
After
14
years
the
cutaneous
lesions
are
still
visible
;
therefore
,
we
conclude
that
the
DPA-induced
cutaneous
damage
is
irreversible
.
Diseases
Validation
Diseases presenting
"abnormal elastic fibers from the upper dermis through the epidermis"
symptom
cystinuria
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