“Lumpy‐Bumpy” Elastic Fibers in the Skin and Lungs of a Patient with a Penicillamine‐Induced Elastosis Perforans Serpiginosa

Penicillamine-induced cutaneous elastosis perforans serpiginosa associated with a large air-cyst in the right lung is described in a 29-year-old female patient with Wilson disease. Identical light and electron-microscopic changes were present in both dermal and pulmonary elastic tissue, suggesting a disseminated drug-induced cutaneo-visceral elastosis. Lung cysts have not been previously reported in association with long term penicillamine treatment. The electron-microscopic morphology of the elastic fibers was found to be “specific” enough to allow separation of penicillamine-induced elastosis perforans serpiginosa from other forms of this disease.