Metals

nickel

zinc

•	zinc deficiency = acrodermatitis enteropathica

•	zinc oxide (used in sunscreens, and to treats diaper rash (Desitin))

iron

•	PCT hepatic iron overload is present in nearly every case of PCT and plasma iron is raised in up to 50% of patients

•	hemochromatosis

aluminum

•	aluminum chloride

•	aluminum subacetate

silver

•	silver nitrate

•

argyria

mercury

•

acrodynia

inorganic arsenic – Fowler’s solution, Gay’s solution (for asthma), well water

•	“raindrops on a dusty road”

•	arsenical keratoses; arsenical carcinomas

•	arsenical melanosis – dark black, generalized hyperpigmentation , with depigmented macules on the trunk that resemble raindrops

•	Mee’s lines – transverse white striations on the fingernails

(organic arsenic – used to be used to treat syphilis (Salvanson’s, Ehrlich’s 606); does not produce these kinds of changes)

•	Wilson’s disease increased serum copper, decreased serum ceruloplasm

•	Menke’s kinky hair decreased serum copper, decreased ceruloplasmin (= diagnostic)

•	X-linked recessive cutis laxa (AKA type IX Ehlers Danlos)

•	copper deposition as cause of green hair discoloration in swimmers

•	penicillamine (--> EPS)

•	Wilson’s disease

•	penicillamine --> EPS

•

X-linked:

•	X-linked cutis laxa

•	Menke’s kinke hair

•	type IX ED

Metal:	Dermatology:

Antimony	antimony compounds are treatment of choice in oriental sore variant of leishmaniasis

Aluminum	aluminum chloride – plugs sweat ducts

	aluminum subacetate = burrows solution (combines with tissue proteins and helps to dry)

Gold	a therapeutic agent for pemphigus

	nitritoid reaction – seen with gold thiomalate; vasomotor reaction (resembling that following the administration of nitrites); get red and dizzy

Lithium	exacerbates both acne and psoriasis

	affects neutrophil chemotaxis (often pustular exacerbation)