Elastosis perforans serpiginosa: a case of a penicillamine-induced degenerative dermatosis.

nated glove (4H) appears relatively impermeable toMMA,but widespreaduse is limitedby cost anddiminisheddexterity.2,3 Allergic contact dermatitis inducedbyMMAmay result in significant discomfort and is seen frequently after occupational exposure amongdentists, dental technicians, orthopedic surgeons, andotherhealthcareworkers. Second-andthirddigit fingertips are commonly involved.3 Nail dystrophy and fingertip paresthesias have also been reported.4 Severe cases of MMA-induced dermatitis can even necessitate profession changes.3 Purpuric contact dermatitis has been reported in patients sensitized to agents such as textile dyes, formaldehyde, and epoxy resins.5We report herein the secondcase, toour knowledge, of MMA-induced PCD.6 Although patch testing is considered thediagnosticgold standard for suspectedallergic contact dermatitis, this patient’s strong contact history and rapid, sustained resolutionof symptomswith allergen avoidance allowed for clinical diagnosis. Fingertip purpura may appear alarming to unsuspecting clinicians and may prompt an extensive workup.We encourage physicians to consider PCD in patients with potential contact exposures.