Repigmentation of Vitiligo Under Penicillamine Therapy for Rheumatoid Arthritis

Abstract

To the Editor.— The editorial by Norlund and Lerner in the JanuaryArchives(1982;118:5-7) points out the importance of vitiligo, its systemic nature, and its relationship to autoimmune disorders. I have seen a patient with widespread vitiligo who had rheumatoid arthritis. When he was receiving penicillamine treatment of this condition, repigmentation recurred within the vitiliginous patches. This observation may be of theoretic and practical interest. Report of a Case.— A 41-year-old man was first seen in July 1979 with a six-month history of generalized arthralgias with swelling. He had had vitiligo of the face, trunk, and extremities for about 15 years. The most recent lesions had appeared on the forearms and on the nape of the neck. On physical examination, synovitis of the wrists, knees, and metatarsophalangeal joints was found. The skin changes showed sharp demarcation between the pigmented and depigmented areas. The ESR was elevated, a rheumatoid factor test