Int J Immunopathol Pharmacol. 2011 Jan-Mar;24(1):257-9. doi: 10.1177/039463201102400133.
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.
穿孔性弹性组织离解症（EPS）是一种罕见的并发症，与大剂量 D-青霉胺（每天 1 克，超过 5 年）慢性治疗有关，其特征是通过表皮从真皮上层消除异常弹性纤维。D-青霉胺（DPA）是一种重金属螯合剂，主要用于胱氨酸尿和威尔逊病等疾病。这种治疗方法可能通过一种尚未明确的机制导致 EPS 的发生。我们报告了一例由 D-青霉胺引起的威尔逊病患者的 EPS 随访情况，这促使我们改用三乙烯四胺（另一种金属螯合剂）进行治疗。14 年后，皮肤病变仍然可见；因此，我们得出结论，DPA 引起的皮肤损伤是不可逆转的。
