Ultrastructure of the skin of patients treated with sodium aurothiomalate

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Abstract
Skin biopsies from rheumatoid arthritis patients treated with sodium aurothiomalate were examined with EM. Intralysosomal Au deposits were found in macrophages of normal-looking skin and from areas of erythematous rash that had developed as a toxic manifestation of chrysotherapy. The main difference between affected and normal-looking skin was the presence of numerous mast cells in the former. Dermatologic side-effects of Au are probably mediated by release of vasoactive substances from mast cells; vigorous administration of antihistamines to neutralize liberated products of mast cells or an agent that interferes with degranulation of mast cells might have a palliative effect on the skin rash that sometimes develops during chrysotherapy.