Skin Complications of Gold Treatment

SummaryReports on the incidence of cutaneous side effects of gold treatment are rather conflicting. Generally, some type of cutaneous complication should be anticipated in every 3rd or 4th course of chrysotherapy. Skin changes are the most common and amount to about one-half of all complications of gold treatment. The clinical picture in gold dermatitis varies widely from case to case. Formerly the prognosis was generally considered favourable. There is no definite information on the pathogenesis, but some theories are mentioned.A number of cases of gold dermatitis treated in the Department of Dermatology of Södersjukhuset presented a course different from the common conception of gold dermatitis. Of these cases, 7 are discussed. In several cases the gold concentration in the skin was determined with the aid of a method, details of which are given.It is pointed out that gold dermatitis is presumably more common than has previously been believed. Owing to the tendency of gold dermatitis to simulate other skin diseases, e.g. eczema pityroides or psoriasis, and to the frequently long latent period between gold treatment and onset of cutaneous symptoms, the true nature of the condition from the point of view of etiology may easily be overlooked. The variation of the clinical picture is emphasized. In many instances the prognosis is probably much more serious than previously supposed, as several cases ran an extremely protracted, recurrent and stubborn course.Gold was demonstrated in the skin 6 years after chrysotherapy. The gold concentration in some cases probably varies appreciably in different areas of the integument, that is to say, in macular lesions the amount of gold seems to be higher than in the surrounding, apparently normal skin.