Lichenoid lesions of the oral mucosa in rheumatoid arthritis patients treated with penicillamine.

Seven of 56 consecutive patients taking penicillamine for rheumatoid arthritis developed oral lesions that clinically and histologically resembled lichen planus. All 7 patients had rashes with prior gold therapy and 4 had rashes with penicillamine therapy. Lesions appeared between 3 and 12 months of therapy at an average dose of 400 mg/day and disappeared within 3 months of stopping the medication. Discontinuation of the drug for oral lichenoid lesions is not necessary. Topical steroids can be used for symptomatic relief.