Systemic Contact Dermatitis Due to Auranofin

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  • 経口金製剤による全身性接触皮膚炎
  • 症例報告 経口金製剤による全身性接触皮膚炎
  • ショウレイ ホウコク ケイコウキン セイザイ ニ ヨル ゼンシンセイ セッショク ヒフエン

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<p>Gold compounds used in treating rheumatoid arthritis often induce a skin rash referred to "gold dermatitis". However, systemic contact dermatitis due to gold compounds in the patients who had already been sensitized percutaneously has rarely been reported. We report herein a case of a 53-year-old woman with systemic contact dermatitis to auranofin, an oral chrysotherapeutic agent. She had been treated with auranofin based on a provisional diagnosis of rheumatoid arthritis two days before presentation. Generalized erythematous lesions and fever developed the next morning after the initial intake of auranofin. The lesions were maculopapular erythemas with occasional vesicles, and they tended to fuse, especially on the intertriginous and flexural areas. She had already been aware of gold allergy, because of a history of finger and ear lobe dermatitis caused by gold accessories. Based on the clinical features and history of contact allergy to metal, we diagnosed her with systemic contact dermatitis to auranofin. Treatment of oral prednisolone 30 mg/day has immediately cleared her symptoms. A patch test showed positive reactions to mercury salts as well as gold salts. Although systemic contact dermatitis to gold compounds has hardly been mentioned in the literature, dermatologists should be aware of this condition, which causes extensive rash and systemic symptoms similar to mercury dermatitis due to metallic mercury inhalation.</p>

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