chrysiasis

Chrysiasis
Classification and external resources
ICD-10	L81.8 (ILDS L81.856)

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/05/13 23:55:32」(JST)

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Chrysiasis (Gk, chrysos - 'gold', osis - 'condition of') is a dermatological condition induced by the parenteral administration of gold salts, usually for the treatment of rheumatoid arthritis.^[1]^:859-60 Such treatment has been superseded as the best practice for treating the disease because of "numerous side effects and monitoring requirements, their limited efficacy, and very slow onset of action".^[2]

Similar to silver, a gold preparation used parenterally for a long period may rarely produce a permanent skin pigmentation - especially if the skin is exposed to sunlight or artificial ultraviolet radiation.

The skin's pigmentation (in this condition) has been described as uniformly gray, grayish purple, slate gray, or grayish blue, and is usually limited to exposed portions of the body. It may involve the conjunctivae over the scleras but usually not the oral mucosa. Location of pigment predominantly in the upper dermis leads to the blue component of skin color through the scattering phenomenon. It is much less likely to be deposited in the nails and hair.

Chrysiasis was said to have been much more common when medicines containing traces of gold were used for treatment of tuberculosis (commonplace forms of treatment nearly fifty years ago). Treatments containing gold traces were also used to treat cases of rheumatoid arthritis - but because the dose used for tuberculosis was higher than for arthritis, it has not afflicted many subscribing to such treatments.

Gold can be identified in the skin chemically by light microscopy, electron microscopy, and spectroscopy.

There is no way to reverse or treat chrysiasis.

Notes

^ James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN 0-7216-2921-0.
^ http://www.hopkins-arthritis.org/arthritis-info/rheumatoid-arthritis/rheum_treat.html#gold

References

Jeghers - New England Journal of Medicine, Vol. 231: 122 & 181, 1944
Scamberg - "Chrysoderma - A permanent gold staining of the skin". Archives of Dermatology & Syphilis, Vol. 18. 862, 1928
The University of Massachusetts Online Article on Skin Pigmentation Disorders [1]

UpToDate Contents

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1. 金治療の主な副作用 major side effects of gold therapy
2. 関節リウマチの眼症状 ocular manifestations of rheumatoid arthritis
3. 皮膚色素過剰症に対するレーザーおよび光線療法 laser and light therapy for cutaneous hyperpigmentation

English Journal

[Corneal chrysiasis. Gold salt deposits in the cornea in a patient with rheumatoid arthritis. An analysis with confocal microscopy].

Santos-Bueso E1, Ahmed-Wasfy M, Sáenz-Francés F, Gil-de-Bernabé J, Martínez-de-la-Casa JM, Benítez-del-Castillo JM, García-Feijoo J.
Archivos de la Sociedad Española de Oftalmología.Arch Soc Esp Oftalmol.2013 Jun;88(6):237-9. doi: 10.1016/j.oftal.2012.09.017. Epub 2012 Dec 21.
CASE REPORT: A 60-year-old woman with rheumatoid arthritis of 20 years onset, on treatment with monthly intramuscular gold salts (GS) for the last 7 years. She complained of suffering from halo vision, and the examination showed a visual acuity of 0.6 in both eyes (BE). The slit lamp showed some dep
PMID 23726309

Ulcerative keratitis following particulate elemental gold deposition.

Raj A1, Williams GP, Hawksworth NR.
Journal of ocular pharmacology and therapeutics : the official journal of the Association for Ocular Pharmacology and Therapeutics.J Ocul Pharmacol Ther.2012 Jun;28(3):323-5. doi: 10.1089/jop.2011.0144. Epub 2011 Dec 23.
PURPOSE: To describe a case of 68-year-old male industrial chemist who received a chemical injury after a gold/amine compound exploded causing bilateral eye injuries. No apparent long-term problems were anticipated. After cataract extraction 40 years later, he developed a localized ulcerative kerati
PMID 22196139

Differential diagnosis of Schnyder corneal dystrophy.

Weiss JS1, Khemichian AJ.
Developments in ophthalmology.Dev Ophthalmol.2011;48:67-96. doi: 10.1159/000324078. Epub 2011 Apr 26.
Schnyder corneal dystrophy (SCD) is a rare corneal dystrophy characterized by abnormally increased deposition of cholesterol and phospholipids in the cornea leading to progressive vision loss. SCD is inherited as an autosomal dominant trait with high penetrance and has been mapped to the UBIAD1 gene
PMID 21540632