Penicillamine-Induced Localised Cutis Laxa in a Patient with Wilson Disease: A Case Report

Introduction: Wilson disease is a rare genetic disorder, characterised by excessive deposition of copper in the liver, brain, and other tissues.Penicillamine, a copper-chelating agent, is used in high doses in the treatment of Wilson disease leading to a variety of cutaneous reactions, including hypersensitivity reactions, pseudoxanthoma elasticum, elastosis perforans serpiginosa, anetoderma, and cutis laxa (CL).We present a rare case of localised CL induced by penicillamine for Wilson disease, in the absence of elastosis perforans serpiginosa.Case Description: A 41-year-old male with Wilson disease treated with long-term high-dose penicillamine was referred to us for a basal cell carcinoma on the scalp.On physical examination, diffusely flaccid and redundant skin on the right side of the neck were observed.Histopathology revealed findings consistent with CL.Conclusion: Long-term treatment with penicillamine for Wilson disease may induce localized CL, possibly by direct inhibition of cross-linkage of collagen fibres.