Marsden R A, Dawber R P, Millard P R, Mowat A G
Br J Dermatol. 1977 Oct;97(4):451-2. doi: 10.1111/j.1365-2133.1977.tb14257.x.
A patient with arthritis is described who developed a dermatitis herpetiformis-like rash after 8 months of D-penicillamine therapy and which cleared soon after the drug was discontinued. The histopathological findings were compatible with a diagnosis of pemphigus, showing intra-epidermal vesicles and spongiosis but no acantholysis. Intercellular antibody was detected by indirect immunofluorescence at the onset of the eruption (titre 1 in 160) and also found in serum taken prior to penicillamine treatment (titre 1 in 20). It is now well known that D-penicillamine can induce pemphigus. The findings reported here suggest the possibility that the patient was predisposed to develop the eruption before the drug was given.
本文描述了一名关节炎患者，该患者在接受青霉胺治疗8个月后出现了疱疹样皮炎皮疹，停药后皮疹很快消退。组织病理学检查结果符合天疱疮的诊断，表现为表皮内水疱和海绵形成，但无棘层松解。在皮疹发作时通过间接免疫荧光检测到细胞间抗体（滴度为1:160），在青霉胺治疗前采集的血清中也检测到了该抗体（滴度为1:20）。现在已经众所周知，青霉胺可诱发天疱疮。此处报告的研究结果提示，该患者在用药前就有可能易患此皮疹。
