Ghadially F N, DeCoteau W E, Huang S, Thomas I
J Pathol. 1978 Feb;124(2):77-83. doi: 10.1002/path.1711240203.
Skin biopsies from cases of rheumatoid arthritis treated with sodium aurothiomalate were examined with the electron microscope. Intralysosomal gold deposits were found in the macrophages of both normal-looking skin and from areas of erythematous rash that had developed as a toxic manifestation of gold therapy. The main difference between affected and normal-looking skin was the presence of numerous mast cells in the former. It is hence suggested that the dermatologic side-effects of gold are probably mediated by the release of vasoactive substances from mast cells and that vigorous administration of antihistamines to neutralise the liberated products of mast cells or an agent that interferes with degranulation of mast cells might have a palliative effect on the skin rash that sometimes develops during chrysotherapy.
对用硫代苹果酸金钠治疗的类风湿性关节炎病例的皮肤活检标本进行了电子显微镜检查。在外观正常的皮肤以及作为金疗法毒性表现而出现的红斑疹区域的巨噬细胞中均发现了溶酶体内的金沉积物。受累皮肤与外观正常皮肤的主要区别在于前者存在大量肥大细胞。因此提示，金的皮肤副作用可能是由肥大细胞释放血管活性物质介导的，大力给予抗组胺药以中和肥大细胞释放的产物或使用干扰肥大细胞脱颗粒的药物可能对金疗法期间有时出现的皮疹有缓解作用。
