Paul I. Dantzig, MD
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Dantzig P.; A New Cutaneous Sign of Mercury Poisoning. Ann Intern Med. 2003;139:78-80. doi: 10.7326/0003-4819-139-1-200307010-00023
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Published: Ann Intern Med. 2003;139(1):78-80.
TO THE EDITOR:
Background: Long-term mercury poisoning is becoming a major health problem because of the extreme toxicity of mercury and its extensive pollution in the environment. However, mercury poisoning is difficult to diagnose. I report on 11 patients who contracted mercury poisoning by eating seafood. In these patients, poisoning manifested with a specific eruption characterized by nonpruritic, discrete, flesh-colored or slightly erythematous papules and papulovesicles. These lesions were small (≤ 1 mm in diameter) and correlated with serum mercury levels; they resolved when mercury levels decreased.
Results: The patients ranged in age from 25 to 75 years, and duration of the eruption before diagnosis and initiation of treatment ranged from 1 week to 2 years (Table). Two patients had noncutaneous symptoms, including dizziness, memory loss, and gastrointestinal (GI) bleeding. Blood mercury levels before treatment ranged from 29.9 nmol/L to 94.7 nmol/L (mean, 49.9 nmol/L). Previous treatments included topical steroids (9 patients), oral steroids (4 patients), antihistamines (2 patients), and cyclosporine (1 patient), all of which were unsuccessful. None of the patients had a personal or family history of atopy (asthma, hay fever, or atopic dermatitis), exposure to mercury (either industrial or incidental, other than seafood), or allergic reactions to metals. None of the patients reported pruritus or pain, although some reported very mild discomfort.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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