Millard P R, Chaplin A J, Venning V A, Wilson C, Wallach R
E.M. Unit, John Radcliffe Hospital, Oxford, UK.
Histopathology. 1988 Sep;13(3):281-8. doi: 10.1111/j.1365-2559.1988.tb02039.x.
Two patients receiving gold therapy for rheumatoid arthritis developed skin pigmentation, chrysiasis, which in one appeared 4 months after cessation of the therapy. The diagnosis was confirmed by transmission electron microscopy and mass spectrometry laser microprobe analysis of paraffin sections and its extent demonstrated by epipolarized light. The condition is poorly reported and clinically may be confused with silver and mercury impregnation. Tissue diagnosis requires ancillary methods and of these, transmission electron microscopy and laser microprobe mass spectrometry are excellent examples. The transmission electron microscopy findings differ from previous reports and raise doubts on the hypothesis on the role of the skin in gold excretion. Because of the renewed interest in crysotherapy and the latent period that can separate this from chrysiasis, an increase in chrysiasis and the need for its diagnosis can be anticipated.
两名接受金疗法治疗类风湿性关节炎的患者出现了皮肤色素沉着，即金沉着病，其中一名患者在停止治疗4个月后出现。通过对石蜡切片进行透射电子显微镜检查和激光微探针质谱分析证实了诊断，并通过偏光显微镜确定了其范围。这种情况报道较少，临床上可能会与银和汞沉着相混淆。组织诊断需要辅助方法，其中透射电子显微镜检查和激光微探针质谱分析就是很好的例子。透射电子显微镜检查的结果与先前的报道不同，这对皮肤在金排泄中的作用这一假说提出了质疑。由于对冷冻疗法的兴趣再度兴起，且冷冻疗法与金沉着病之间可能存在潜伏期，预计金沉着病的发病率将会增加，对其诊断的需求也会增加。
