A case of drug eruption with thiomalate hypersensitivity induced by gold sodium thiomalate.
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A 61-year-old Japanese woman had eruptionsand alopecia after seven months of gold therapyfor rheumatoid arthritis. The total dosageof gold sodium thiomalate (GTM) administeredwas 110 mg. Both the clinical and histologicpicture showed lichenoid eruption. The eruption disappeared with pigmentationand the hair of the scalp was almost recoveredhalf a year after discontinuance of the goldtherapy. Injection of GTM was resumed, anda similar reaction of the skin again developedabout three months later.An intracutaneous test with 0.1ml of 1%GTM showed a positive reaction and a patchtest with 5% thiomalate (TM) was also positiveone. But no reaction to the metal gold wasdetected in the patch test. The peak of skinreactions was 24 hours later in the intracutaneoustest and 72 hours later in the patch test.Therefore we presume that at least a delayedhypersensitivity to TM, which is the thiolcarrier of GTM, is invoived in the developmentof this lichenoid GTM eruption.
- 日本皮膚科学会大阪地方会の論文
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