Department of Dermatology, John P. and Kathrine G. McGovern Medical School at the University of Texas Health Science Center at Houston, USA.
Cutis. 2020 Nov;106(5):265-267. doi: 10.12788/cutis.0113.
Mercury poisoning is a rare event that can present with a variety of nonspecific systemic symptoms, making it difficult to diagnose. Dermatologic manifestations of mercury exposure may be variable and include pink disease (acrodynia), mercury exanthem, contact dermatitis, and cutaneous granulomas. We present the case of an 18-year-old woman with a palmoplantar eruption associated with tachycardia, hyperhidrosis, myalgia, paresthesia, and muscle fasciculations. Physical examination demonstrated poorly demarcated pink macules coalescing into patches on the left palm, right wrist, and soles. A punch biopsy was nonspecific, showing acanthosis and orthokeratosis with mild inflammation. Elevated urine and serum mercury levels confirmed a diagnosis of mercury poisoning. This case highlights the importance of consideration of mercury poisoning in the differential diagnosis for acral eruptions, especially in the presence of systemic symptoms and known risk factors.
汞中毒是一种罕见的疾病，可能表现出多种非特异性全身症状，因此难以诊断。汞暴露的皮肤表现可能多种多样，包括粉红病（肢端感觉异常）、汞疹、接触性皮炎和皮肤肉芽肿。我们报告了一例 18 岁女性患者，其手掌和足底出现皮疹，伴有心动过速、多汗症、肌痛、感觉异常和肌肉抽搐。体格检查显示左手掌、右手腕和足底边界不清的粉红色斑丘疹融合成斑块。皮肤活检非特异性，表现为棘层肥厚和正角化，伴有轻度炎症。尿汞和血清汞水平升高证实了汞中毒的诊断。本病例强调了在肢端皮疹的鉴别诊断中考虑汞中毒的重要性，尤其是在存在全身症状和已知危险因素的情况下。
