Decline of anti‐desmoglein 1 IgG ELISA scores by withdrawal of d‐penicillamine in drug‐induced pemphigus foliaceus

A case of pemphigus foliaceus arising during the administration of d‐penicillamine was reported. A 72‐year‐old woman with systemic sclerosis developed flaccid vesicles and crusted erythema of the skin after administration of d‐penicillamine for 1‐year. She was positive for anti‐desmoglein 1 IgG by ELISA. The withdrawal of d‐penicillamine resulted in improvement of the skin lesions and ELISA scores for anti‐demoglein 1 antibodies revealed a surprisingly rapid decline. This case is a classical incidence of drug‐induced pemphigus foliaceus, in which d‐penicillamine was constantly required not only to induce, but also to maintain the production of the autoantibodies.

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