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[Cutaneous reactions to gold salts]
1Service de Dermatologie, CHRU Dupuytren, Limoges.
Presse Medicale (Paris, France : 1983)
|October 26, 1996
Summary
Gold salts treat rheumatoid arthritis and dermatoses but carry risks of cutaneous reactions. Diagnosis is challenging as reactions mimic other skin conditions, requiring careful dermatological assessment.
Area of Science:
- Dermatology
- Rheumatology
- Pharmacology
Context:
- Gold salts are utilized for rheumatoid arthritis and refractory dermatoses like pemphigus.
- They inhibit endothelial cell adhesion molecules, with varying efficacy among different gold compounds.
- Thiomalate alone demonstrates similar inhibitory effects.
Purpose:
- To review the cutaneous reactions associated with gold salt therapy.
- To elucidate the diagnostic challenges and potential mechanisms of these adverse events.
- To identify patient risk factors and guide clinical management.
Summary:
- Patients receiving gold salts face a significant risk of cutaneous reactions, often mimicking other dermatoses, complicating diagnosis.
- Common adverse events include pruritus, exanthemas, stomatitis, and contact dermatitis, with rarer severe hypersensitivity reactions.
- Risk factors for gold drug reactions include smoking, HLA Bw35 status, and atopy; immunological adverse events are most frequent.
Impact:
- Highlights the diagnostic difficulties and varied presentation of gold-induced dermatoses.
- Emphasizes the need for thorough dermatological evaluation and consideration of visceral side effects.
- Suggests that skin tests are unreliable for diagnosing gold hypersensitivity.