D-penicillamine in systemic sclerosis? Yes!

The use of D-penicillamine in systemic sclerosis (SSc) has been controversi al. We have reviewed the major published studies on this drug in SSc with d iffuse cutaneous (dc) involvement and summarized our own recent experience in dcSSc patients treated with and without D-penicillamine. We conclude tha t D-penicillamine favourably alters the natural history of skin involvement in dcSSc. even when used in low dose. Furthermore, recurrence of diffuse s kin change after discontinuation of D-penicillamine and improvement in skin thickening after reinitiation of the drug support its effectiveness. We be lieve that the rheumatologic community should use D-penicillamine in patien ts with early dcSSc.