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Penicillamine for systemic sclerosis?


Penicillamine has an accepted place as a chelating agent in the therapy of Wilson’s disease and lead poisoning. More recently it has been found of value in rheumatoid arthritis.1 Its effect on collagen tissue came to light when it was noted that in patients on long-term penicillamine the skin was much less resistant to trauma.2 This observation led to its trial in systemic sclerosis. A possible explanation of the effect was suggested by animal experiments which showed that penicillamine significantly reduced the amount of insoluble collagen in artificially induced granulomata in rats.3 This reduction was almost balanced by an increase in the soluble collagen. The alteration in collagen solubility occurs in the skin and in tendon, but not in aorta or gut wall.4

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