Long-term penicillamine therapy has been associated with alterations in dermal elastic tissue. Well-described associated dermatoses include pseudo-pseudoxanthoma elasticum, acquired cutis laxa, elastosis perforans serpiginosa, and anetoderma. Histologically, “lumpy-bumpy”" or “bramble-bush”" morphologic changes of elastic fibers in the dermis are characteristic. Previous reports of these findings in normal-appearing skin and internal organs suggest a systemic elastolytic process. Here we report an unusual case of penicillamine-induced elastosis affecting the mucosa of the lip with characteristic histologic features.