EPS and acquired cutis laxa are rare dermatoses associated with elastin fibre changes, often induced by penicillamine, a drug used to treat Wilson disease, cystinuria and rheumatoid arthritis.1 Up to 50% of patients using penicillamine experience cutaneous adverse effects.1 Long-term use induces elastin fibre changes through two primary mechanisms. The gene discussed is ELN; the disease is rheumatoid arthritis.