Gold dermatitis L27.04

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Definition
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Non-specific dermatitis as a side effect of gold therapy (chrysotherapy) in rheumatoid arthritis or other diseases. Incidence up to 53% of patients treated with gold. These are dose-dependent toxic changes which, in contrast to chryssiasis, are reversible.

Clinical features
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Maculopapular, erythematosquamous, lichenoid, vesicular or urticarial skin changes. Often severe pruritus.

Therapy
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If the skin symptoms are less severe, an interruption of the therapy or, if possible, a reduction in dose can significantly improve the skin appearance and pruritus. Only in severe cases it is necessary to remove the gold. Exanthema can persist for months even after discontinuation of therapy. In these cases long-term systemic therapy with glucocorticoids such as prednisolone (e.g. Decortin H) in medium dosages: 20-50 mg/day.

External therapy
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Blande local therapy e.g. with Lotio alba aq. or weakly effective glucocorticoid-containing topical preparations such as 1% hydrocortisone cream R121 R120.

Literature
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  1. Eisler R (2003) Chrysotherapy: a synoptic review. Inflamm Res 52: 487-501
  2. Fritsch P et al (1996) Metal Dermatoses II. dermatologist 47: 400-409
  3. Nonaka H et al (2003) Gold allergy in Japan. Contact Dermatitis 48: 112-114

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 29.10.2020