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A Clinical, Immunohistologic, and Ultrastructural Study

Jeffrey B. Goldstein, MD; N. Scott McNutt, MD; George W. Hambrick, Jr, MD; Hsu Amy

Arch Dermatol. 1989;125(1):92-97.

Abstract
• The term penicillamine dermatopathy refers to the characteristic hemorrhagic skin lesions found in persons receiving long-term penicillamine therapy for either Wilson's disease or cystinuria. These lesions are thought to develop as a result of faulty collagen and elastin synthesis. We describe a patient with Wilson's disease who developed extensive penicillamine dermatopathy. In addition, histologic, immunochemical, and ultrastructural studies revealed multiple lymphangiectases with blood vessel to lymphatic anastomosis within these lesions, a finding not previously reported. The possible relationship to defective collagen and elastin formation are considered.

(Arch Dermatol 1989;125:92-97)

Author Affiliations
From the Departments of Medicine (Dermatology) (Drs Goldstein, McNutt, and Hambrick), Pathology (Dr McNutt and Ms Hsu), New York Hospital-Cornell University Medical College, New York.

Footnotes
Accepted for publication Aug 4, 1988.

Presented in part at the annual meeting of the American Academy of Dermatology, San Antonio, Tex, Dec 7, 1987.

Reprint requests to Dermatopathology (F-309), New York Hospital, 525 E 68th Street, New York, NY 10021 (Dr McNutt).

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