Smith R W, Leppard B, Barnett N L, Millward-Sadler G H, McCrae F, Cawley M I
Department of Rheumatology, Southampton University Hospitals, UK.
Br J Dermatol. 1995 Nov;133(5):671-8. doi: 10.1111/j.1365-2133.1995.tb02737.x.
Chrysiasis is a distinctive and permanent pigmentation of light-exposed skin resulting from the administration of parenteral gold salts. We report a study of 40 Caucasian patients with rheumatoid arthritis, treated with intramuscular sodium aurothiomalate, of whom 31 had chrysiasis. Visible changes develop above a threshold, equivalent to 20 mg/kg gold content, and their severity depends upon cumulative dose. Focal aggregates of particulate gold are deposited in the reticular and papillary dermis in amounts that correlate with the degree of pigmentation. Characteristically, initially the periorbital region is affected by a mauve discoloration, which intensifies and deepens into a blue/slate-grey colour, while extending to involve the face, neck and upper limbs. Although chrysiasis develops insidiously and patients may be unaware of the changes, positive identification is important in order to avoid misdiagnosis and medical mismanagement, and afford appropriate reassurance. Prevention is difficult, but measures to reduce sunlight exposure may be helpful.
金沉着病是因胃肠外给予金盐而导致的曝光部位皮肤独特且持久的色素沉着。我们报告了一项针对40例高加索类风湿关节炎患者的研究，这些患者接受了肌肉注射硫代苹果酸金钠治疗，其中31例发生了金沉着病。可见变化在相当于20mg/kg金含量的阈值以上出现，其严重程度取决于累积剂量。颗粒状金的局灶性聚集物沉积在网状真皮和乳头层真皮中，其数量与色素沉着程度相关。典型表现为，最初眶周区域出现淡紫色变色，随后加深并扩展为蓝/石板灰色，同时累及面部、颈部和上肢。尽管金沉着病起病隐匿，患者可能未意识到这些变化，但准确识别对于避免误诊和医疗管理失误以及给予适当的安心很重要。预防虽困难，但减少阳光照射的措施可能有所帮助。
