Park Jeong Young, Shin Dong Hoon, Choi Jong Soo, Kim Ki Hong
Department of Dermatology, College of Medicine, Yeungnam University, Daegu, Korea.
Ann Dermatol. 2013 Aug;25(3):356-9. doi: 10.5021/ad.2013.25.3.356. Epub 2013 Aug 13.
The differential diagnosis of bluish-gray pigmentation of the skin includes dermal melanocytosis, malignant melanoma and metallic discoloration. Of these disorders, metallic discoloration, which develops from deposits of fine metallic particles on the skin, is an uncommon dermatologic disease. We report a case of metallic discoloration of the right shin caused by titanium alloy prostheses in a patient with right total knee replacement. The patient had bluish-gray pigmentation on her right shin as well as pain while walking. Histopathologic findings of the skin lesion showed abundant black particles in the perivascular area of the lower dermis. Polarizing microscopy revealed refractile foreign materials in the dermis. An energy dispersive X-ray spectrophotometer unit attached to a transmission electron microscope detected titanium and aluminium peaks in the specimen.
皮肤蓝灰色色素沉着的鉴别诊断包括真皮黑素细胞增多症、恶性黑色素瘤和金属变色。在这些疾病中，金属变色是一种罕见的皮肤病，它是由皮肤表面细小金属颗粒沉积所致。我们报告一例全膝关节置换术后患者因钛合金假体导致右小腿金属变色的病例。该患者右小腿有蓝灰色色素沉着，行走时伴有疼痛。皮肤病变的组织病理学检查发现真皮下部血管周围区域有大量黑色颗粒。偏振光显微镜检查显示真皮中有可折射的异物。连接在透射电子显微镜上的能量色散X射线光谱仪在标本中检测到钛和铝的峰值。
