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Hi. I was using colloidal silver over two years before
I got oral Lichen Planus. Here is a post to this list from last
February.
Adverse Effects of Gold Avoid gold. . . I'm wondering if it is what has
lead to this lichen planus sore area on my gum which I've had for over two
years now. I used some colloidal gold about 6 months before I got the
sores. I also started wearing mineral makeup, see below how that can cause
problems. (Lichen planus is most common in
middle age people.) Non-steroidal anti-inflammatories and blood pressure
drugs have also been blamed in some articles. I just found these
articles.
Pat
Adverse Effects
Toxic reactions occur in approximately 32% of patients receiving intramuscular
gold sodium thiomalate (Myochrysine) for rheumatoid arthritis ("Arthritis
and Allied Conditions" [Philadelphia: Lea and Febiger, 1972, pp. 455-82]).
Skin reactions account for 60% of these side effects (Ann. Rheum. Dis.
1960;19:95-119).
There is a broad spectrum of cutaneous side effects following gold therapy. In
most cases a nonspecific dermatitis can be observed, mainly on the chest, arms,
and legs. The skin lesions may also mimic lichen planus, pityriasis rosea, or
various forms of eczema, obscuring early diagnosis (Z. Rheumatol.
1986;45:100-6).
Histologically, Hofmann et al. described four types of reactions caused by
gold: a dermatitis type, a vasculitis type, a lichenoid type, and an urticarial
type (Z. Rheumatol. 1986;45:100-6).
Lichen Planus
Lichen planus is an inflammatory mucocutaneous condition with characteristic
violaceous polygonal flat-topped papules and plaques that are intensely
pruritic.
Involvement of the oral mucosa is common, and this condition can be
debilitating in severe cases. Oral lichen planus classically presents on the
buccal
mucosa as a white, lacy, reticular pattern, but erosive lesions can also occur.
Erosive lesions in particular may be exquisitely painful and can lead to
secondary infections; and the pain can lead to poor nutrition and dehydration.
Moreover, patients with long-term oral mucosal lesions have an increased risk
of developing squamous cell carcinoma in the lesions (Oral Surg. Oral Med. Oral
Pathol. 1985;60:30-4).
While most cases of lichen planus are idiopathic, some are caused by the
ingestion of certain medications, notably gold. Furthermore, the association
between oral lichen planus and the use of gold in dental restorations has been
well established for many years (Am. J. Contact Dermatitis 2001;12:146-50).
Interestingly, dermatitis from jewelry is not always seen in patients with oral
mucosal reactions attributed to gold (Contact Dermatitis 1995;33:323-8).
In addition to many case reports of oral lichen planus secondary to
gold-containing dental restorative materials, there have been cases of linear
lichen planus on the lower extremities and nail lichen planus secondary to
gold-containing dental fillers, all of which improved with the removal of the
gold dental restoration (Br. J. Dermatol. 2005;152:1087-9;J. Dermatol.
1996;23:890-2). There have even been cases of cutaneous lichen planus after the
consumption of Goldschlager, a gold-containing cinnamon liquor (N. Engl. J.
Med. 1996;334:603).
Gold Allergy
Prior to the 1980s, allergies to gold were thought to be rare, with only a few
cases reported. Because it was thought to be immunologically inert, gold was
rarely tested for among dermatologists and allergists. This situation allowed
gold allergy to go undetected, and gold was considered an insignificant
allergen ("Fisher's Contact Dermatitis, 5th ed." [Philadelphia:
Williams & Wilkins; 2001]). Gold was added to the North American Contact
Dermatitis Group (NACDG) standard screening panel in the 1996-1998 series, and
quickly became the sixth most common allergen (J. Am. Acad. Dermatol.
1998;38:911-8).
The recognition of gold as a significant sensitizer and as the second most
common metal allergen (only after nickel) led to the designation of gold as
Allergen of the Year in 2001 by the American Contact Dermatitis Society (Adv.
Dermatol. 2004;20:237-55).
An interesting feature of gold allergy is the propensity for facial and eyelid
dermatitis to occur. In fact, gold was the most frequently encountered allergen
associated with eyelid dermatitis in the most recent NACDG data (2003-2004)
(Dermatitis 2007;18:78-81).
It is important to note that gold does not often cause a reaction under
jewelry. Rather, reactions are seen in areas where gold comes in contact with
eye makeup, foundation, and sunscreens, which are items that might contain
metal compounds such as titanium dioxide and zinc oxide. These harder metals
abrade the gold, leading to the release of sensitizing gold particles. Mineral
makeup is thought to be a frequent culprit.
Notably, both the dermatitis and the positive patch test reactions caused by
gold may persist for months after exposure; in one case, the reaction was
reported to last for 18 months ("Fisher's Contact Dermatitis, 5th
ed.," [Philadelphia: Lippincott Williams & Wilkins, 2001];
Dermatologica 1971;142:209-18).
Conclusions
Despite the evidence demonstrating gold's anti-inflammatory efficacy with oral
or intramuscular use, no studies looking at its efficacy and safety in the skin
have been published. The effects of topical gold on the skin are unknown, but
its potential and serious side effects are, including contact dermatitis and
lichen planus, as well as its exorbitant cost: a 1.7-ounce bottle of Orlane
Creme Royale, which contains 24-karat liquid gold, costs $650. Gold leaf
facials ate the current trend in many beauty magazines and are found at
high-end spas for $500 and up.
Companies that incorporate gold into their products should be encouraged to
perform a well-designed trial to look at the efficacy, and very importantly,
the safety of topical gold before consumers feel the impact, not only on their
pocketbooks but also on their skin health.
DR. BAUMANN is director of cosmetic dermatology at the University of Miami. To
respond to this column, or to suggest topics for future columns, write to Dr.
Baumann at our editorial offices via e-mail at [email protected].
DR. MARIA PAZ CASTANEDO-TARDAN, a dermatology fellow at the University of
Miami, also contributed to this month's column.
__________________________________________________________________________________________________________
After the Gold Rash.By: Berger, Joanne M.
Publication: Family Practice News
Date:Sunday, April 15 2001
You are viewing page 1
Here's a nugget at wisdom: Drinking gold may be hazardous to your skin. At a
dermatology meeting, a Kentucky physician described an 18-year-old patient with
a 3-week history of brownish-red scaly papules on his trunk and extremities.
The man did not respond to a mild topical corticosteroid and an
antihistamine (for suspected pityriasis rosea) or to doxycycline (for suspected
pityriasis lichenoides). Then the patient revealed that he'd been drinking
large amounts of Goldschlager, a cinnamon schnapps that contains gold flakes,
on a nightly basis. After he was advised to stop, his condition cleared in a few
days. An earlier case study (N. Engl. J. Med. 334[9]:603, 1996) described a
24-year-old man who developed lichen planus after drinking Gold-schlager for 1
year; his symptoms also cleared when he stopped. With Gold-schlager priced at
about $25 a bottle, don't expect to see a, um, rash of such cases.
_______________________________________________________________________________________________________
But what they fail to address is that while gold was once injected as a
medication for certain inflammatory diseases like arthritis, the treatment has
been largely discontinued due to the manifold side effects.
In a nutshell, there's no evidence that gold is good for the skin - and plenty
of evidence that it can be bad. This skin care trend worries me for two
reasons:
* 1) Allergies: Gold allergies are on the rise - at an
alarming rate. Remember, while we all associate gold with luxury, it's still a
metal, and you can develop an allergy to it. Perhaps you're thinking,
"well, I'm safe - no $600 face creams here!" But in an interesting
development, some of my colleagues in the dermatological community believe that
the rise of mineral makeup is contributing to this rise in gold allergies. The
theory is that those minerals, like bismuth and mica, scratch off small
particles of gold from jewelry, eventually introducing that gold to the skin
and causing the body to mount an allergic reaction. Gold allergy isn't an all
or nothing thing - you can develop it slowly over time.
* 2) Lichen Planus: A skin disease that causes purple
papules, lichen planus is known to be caused by gold. For example, in 1996,
when Goldschlager - a liquor that includes gold particles - was popular, there
was an outbreak of lichen planus associated with the trend.
--
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