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Mucocutaneous reactions to gold: a prospective study of 74 patients with rheumatoid arthritis
A van Gestel1, R Koopman, M Wijnands
1Department of Rheumatology, University Hospital Nijmegen, The Netherlands.
Objective:
To describe causality, morphology, course, and risk factors of mucocutaneous reactions to gold.
Methods:
A prospective study of 74 patients with rheumatoid arthritis starting with gold thioglucose.
Results:
Thirty-nine patients experienced an episode of gold dermatitis. Sixteen patients continued gold treatment. The estimated treatment withdrawal at 1 year was 26%. The clinical picture was variable and nonspecific. Gold dermatitis was associated with HLA-B35 and disease duration.
Conclusion:
Mucocutaneous reactions to gold are nonspecific, therefore a causality assessment is necessary. Incidence is high, but treatment can often be continued with dose reduction and local steroids. The predictive value of risk factors is low.