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Colchicine intoxication diagnosed in a skin biopsy: a case report.

Stephen E Mason1, Bruce R Smoller, Anne E Wilkerson

  • 1Department of Pathology, Vanderbilt University, Nashville, TN 37232, USA. stephen.mason@vanderbilt.edu

Journal of Cutaneous Pathology
|April 25, 2006
PubMed
Summary

Colchicine toxicity can be diagnosed via skin biopsy, revealing characteristic histopathologic findings like metaphase-arrested keratinocytes. This aids diagnosis in patients with altered mental status and rash after colchicine exposure.

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Area of Science:

  • Dermatology
  • Toxicology
  • Pathology

Background:

  • Colchicine toxicity is a rare clinical condition with known histopathologic findings in multiple organ systems.
  • Cutaneous manifestations of colchicine intoxication are infrequently documented in medical literature.

Observation:

  • A case of colchicine toxicity was diagnosed using skin biopsy in a patient presenting with altered mental status.
  • The patient exhibited a diffuse, blanchable, violaceous, morbilliform rash on the trunk and proximal extremities.

Findings:

  • Histopathologic examination of the skin biopsy revealed keratinocytes arrested in metaphase.
  • Underlying basal vacuolization was also noted in the skin biopsy.
  • These dermatopathologic findings, coupled with clinical presentation and exposure history, confirmed colchicine toxicity.

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Implications:

  • Skin biopsy can be a valuable diagnostic tool for colchicine toxicity, especially when other signs are present.
  • Recognizing these specific cutaneous findings can aid clinicians in diagnosing colchicine intoxication.
  • This case highlights the importance of considering dermatopathology in the diagnosis of toxic exposures.