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Related Experiment Videos

Chrysiasis revisited: a clinical and pathological study

R W Smith1, B Leppard, N L Barnett

  • 1Department of Rheumatology, Southampton University Hospitals, UK.

The British Journal of Dermatology
|November 1, 1995
PubMed
Summary

Chrysiasis, a permanent skin pigmentation from gold salt injections, affects patients with rheumatoid arthritis. Severity correlates with cumulative gold dose, appearing as blue-grey discoloration on sun-exposed areas.

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Area of Science:

  • Dermatology
  • Rheumatology
  • Toxicology

Background:

  • Chrysiasis is a permanent skin pigmentation caused by parenteral gold salt administration.
  • It is a known side effect in patients treated with gold salts for conditions like rheumatoid arthritis.
  • Understanding its development and clinical presentation is crucial for patient management.

Purpose of the Study:

  • To investigate the clinical features and dose-dependency of chrysiasis in Caucasian patients with rheumatoid arthritis.
  • To correlate the degree of pigmentation with gold deposition in the skin.
  • To highlight the importance of accurate diagnosis and potential preventive measures.

Main Methods:

  • A study was conducted on 40 Caucasian patients with rheumatoid arthritis treated with intramuscular sodium aurothiomalate.

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  • Clinical observation of skin pigmentation, particularly in light-exposed areas.
  • Assessment of gold content and deposition in dermal layers.

    • Main Results:

    • Chrysiasis was observed in 31 out of 40 patients (77.5%).
    • Visible pigmentation appeared above a threshold of 20 mg/kg gold content.
    • Pigmentation severity correlated with cumulative gold dose and was characterized by a progressive mauve to blue/slate-grey discoloration, initially periorbital and extending to the face, neck, and upper limbs.
    • Focal aggregates of particulate gold were found in the dermis, correlating with pigmentation intensity.

    Conclusions:

    • Chrysiasis is a common, dose-dependent side effect of parenteral gold therapy in rheumatoid arthritis patients.
    • Early identification is essential to prevent misdiagnosis and ensure appropriate patient care.
    • Reducing sun exposure may be a helpful preventive strategy, though chrysiasis is difficult to prevent entirely.