To the Editor: Elastosis perforans serpiginosa (EPS) is part of different kinds of perforating diseases that are dependent on factors such as idiopathic, reactive, or drug induced. We report here a case of a patient who presented with multiple reddish?brown keratinized papules coalescing to form serpiginous plaques in the anterior and posterior of the neck, which was found to be typical D?penicillamine?induced EPS.