Leonard P A, Moatamed F, Ward J R, Piepkorn M W, Adams E J, Knibbe W P
J Rheumatol. 1986 Feb;13(1):58-64.
To investigate the role of sun exposure in the pathophysiology of chrysiasis, we studied 10 Caucasian female patients with rheumatoid arthritis: 4 with clinically apparent chrysiasis and 6 without apparent pigmentation. Three patients without chrysiasis had received over 4 g of gold and 3 less than one g. The mean melanin score, determined by histological examination of sun exposed and nonsun exposed skin, was significantly higher in the sun exposed skin of the chrysiasis and high dose controls than low dose controls (p less than .05). Concentration of gold measured semiquantitatively by transmission electron microscopy and quantitatively by atomic absorption showed increased gold concentration in sun exposed when compared to nonsun exposed skin of chrysiasis and high dose controls (p = .26). Low dose controls had no gold demonstrated by either method. Our results suggest that gold deposition in the dermis stimulates melain production and that melanin is important in hyperpigmentation of chrysiasis. Furthermore ultraviolet light may induce preferential uptake of gold by the skin.
为了研究阳光照射在金中毒病理生理学中的作用，我们对10名患有类风湿性关节炎的白人女性患者进行了研究：4名有明显的金中毒，6名无明显色素沉着。3名无金中毒的患者接受了超过4克的金，3名接受的金少于1克。通过对暴露于阳光和未暴露于阳光的皮肤进行组织学检查确定的平均黑色素评分，在金中毒患者和高剂量对照组暴露于阳光的皮肤中显著高于低剂量对照组（p<0.05）。通过透射电子显微镜半定量和原子吸收法定量测量的金浓度显示，与金中毒患者和高剂量对照组未暴露于阳光的皮肤相比，暴露于阳光的皮肤中金浓度增加（p = 0.26）。低剂量对照组用两种方法均未检测到金。我们的结果表明，真皮中的金沉积刺激黑色素生成，黑色素在金中毒的色素沉着过多中起重要作用。此外，紫外线可能诱导皮肤优先摄取金。
