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Localized chrysiasis induced by laser therapy

M J Trotter1, V A Tron, J Hollingdale

  • 1Department of Pathology, Vancouver Hospital and Health Sciences Centre, University of British Columbia.

Archives of Dermatology
|December 1, 1995
PubMed
Summary
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Localized chrysiasis, a rare skin discoloration, can be triggered by Q-switched ruby laser treatment in patients receiving gold salts. Laser therapy altered the structure of dermal gold deposits, causing the blue-gray skin changes.

Area of Science:

  • Dermatology
  • Laser Physics
  • Materials Science

Background:

  • Chrysiasis is a rare blue-gray skin discoloration associated with gold salt therapy, typically affecting sun-exposed areas.
  • A unique case of localized chrysiasis occurred immediately after Q-switched ruby laser treatment for postinflammatory hyperpigmentation in a patient on gold sodium thiomalate therapy for psoriatic arthritis.

Observation:

  • The blue-gray skin discoloration developed instantly post-laser and remained for over a year.
  • Transmission electron microscopy revealed significant changes in cutaneous gold deposits after laser irradiation.
  • Pre-laser deposits were faceted and larger (106 nm), while post-laser deposits were smaller (16 nm) and spherical, resembling colloidal gold.

Findings:

  • Q-switched ruby laser treatment induced localized chrysiasis in a patient undergoing gold therapy.

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  • The induced chrysiasis resulted from a structural transformation of dermal gold deposits.
  • Pulsed dye laser treatment at 585 nm did not induce similar changes.

    • Implications:

    • This study demonstrates that laser irradiation can alter the physicochemical properties of dermal gold deposits.
    • The findings suggest that UV light-induced modifications of gold deposits may explain the sun-exposed localization of chrysiasis.
    • Understanding these interactions is crucial for managing patients on gold therapy considering laser treatments.