Chrysiasis resulting from gold therapy in rheumatoid arthritis: identification of gold by x-ray microanalysis

A patient with blue-gray discoloration of the skin of her face, neck, and hands is described. She was a patient with rheumatoid arthritis who had received a large total cumulative dose of gold. Light microscopy of skin biopsy tissue from the forehead revealed deposits of heavy metal in macrophages. On electron microscopy, the particles were found in the lysosomes of the cell. X-ray microanalysis confirmed the presence of gold. This condition, which is called chrysiasis, may be incorrectly diagnosed as cyanosis.