Pemphigus-like eruption induced by d-penicillamine and captopril, in the same patient

A patient suffering from rheumatoid arthritis and hypertension is described who developed pemphigus foliaceus during simultaneous treatment with d-penicillamine and captopril. Discontinuation of the d-penicillamine afforded some improvement, but skin symptoms still persisted after 3 months. When the captopril was discontinued as well, all lesions healed within 2 weeks. These findings suggest that both these chemically related drugs might have been responsible for the pemphigus-like eruption in this patient.